Individual
RAPHAEL J STODOMINGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 MARCUS DR STE 308, GREENVILLE, SC 29615-6946
(864) 631-2084
Mailing address
PO BOX 931142, ATLANTA, GA 31193-1142
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-24-78264
—
Other
Enumeration date
06/02/2022
Last updated
01/22/2025
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