Individual
MARK DOMOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 UNIVERSITY DR, HERSHEY, PA 17033-2360
(800) 243-1455
Mailing address
PO BOX 858, HERSHEY, PA 17033-0858
(800) 243-1455
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
01/04/2013
Last updated
01/04/2013
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