Individual
LESLIE E. DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2579 OAK ST, KISSIMMEE, FL 34744-4946
(787) 596-0358
Mailing address
4014 W VINE ST APT 113B, KISSIMMEE, FL 34741-4686
(787) 596-0358
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2745
PR
173C00000X
Reflexologist
—
—
174400000X
Specialist
—
—
225400000X
Rehabilitation Practitioner
—
—
225700000X
Massage Therapist
—
—
Other
Enumeration date
05/10/2007
Last updated
04/08/2025
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