Individual
DAISY DORIS DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
345 SMITH AVE N, SAINT PAUL, MN 55102-2346
(651) 220-8561
Mailing address
58 KING ST E, SAINT PAUL, MN 55107-2924
(651) 399-4776
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
30004
MN
Other
Enumeration date
01/18/2024
Last updated
01/18/2024
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