Individual
DOMINIQUE IRENE GARCIA O'DELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11698 HURON ST UNIT 106, NORTHGLENN, CO 80234-2950
(720) 381-0264
Mailing address
1240 CEDAR AVE APT 25, BOULDER, CO 80304-3144
(857) 225-0503
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/21/2018
Last updated
06/21/2018
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