Individual
HECTOR M DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CACI
Contact information
Practice address
777 RIVERVIEW DR, STE 180 BLDG A, BENTON HARBOR, MI 49022
(269) 926-0121
(269) 926-0584
Mailing address
777 RIVERVIEW DR, STE 180 BLDG A, BENTON HARBOR, MI 49022
(269) 926-0121
(269) 926-0584
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
MI
Other
Enumeration date
06/04/2007
Last updated
07/08/2007
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