Individual
JOSE ALI HERNANDEZ DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
150 E FIRE TOWER RD STE C, WINTERVILLE, NC 28590-8330
(202) 424-3255
Mailing address
150 E FIRE TOWER RD STE C, WINTERVILLE, NC 28590-8330
(202) 424-3255
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
10407A
NC
Other
Enumeration date
03/24/2023
Last updated
06/27/2024
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