Individual
CICLADY DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
509 LAUREL GROVE CIR, SANTA ROSA, CA 95407-5493
(707) 321-6531
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
172V00000X
Community Health Worker
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
08/14/2023
Last updated
08/07/2025
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