Individual
KRISTINA ANGELICA DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
5350 S WESTERN AVE, 525, OKLAHOMA CITY, OK 73109-4520
(405) 355-3239
Mailing address
613 SE JAMAICA DR, BENTONVILLE, AR 72712-3989
(479) 381-4366
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4507
OK
Other
Enumeration date
04/12/2016
Last updated
04/12/2016
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