Individual
MARK ANTHONY DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3825 24TH AVE SE, APT. #5, NORMAN, OK 73071-1770
(580) 320-6021
Mailing address
3825 24TH AVE SE, APT. #5, NORMAN, OK 73071-1770
(580) 320-6021
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5493
OK
Other
Enumeration date
01/26/2016
Last updated
01/26/2016
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