Individual
MS. LISA M DOMENGEAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED.
Contact information
Practice address
25511 BUDDE RD STE 1002, SPRING, TX 77380-2089
(281) 719-5539
(281) 715-4742
Mailing address
162 RUSHWING PL, THE WOODLANDS, TX 77381-4319
(281) 719-5539
(281) 715-4742
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
79369
TX
Other
Enumeration date
09/24/2018
Last updated
09/24/2018
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