Individual
MR. KIMBERLY SUE DOMINIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
1440 E FOUNTAIN BLVD, COLORADO SPRINGS, CO 80910-3502
(719) 238-7264
Mailing address
3155 HOLLYCREST DR, COLORADO SPRINGS, CO 80920-3014
(719) 235-1826
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
956
CO
Other
Enumeration date
11/13/2007
Last updated
03/30/2017
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