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Individual

VICTORIA DOMINGUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
325 N BERGIN LN, BLOOMFIELD, NM 87413-6729
(505) 632-4389
Mailing address
325 N BERGIN LN, BLOOMFIELD, NM 87413-6729
(505) 632-4389

Taxonomy

Speciality
Code
Description
License number
State
1041S0200X
School Social Worker
Primary
X-08774
NM

Other

Enumeration date
02/10/2015
Last updated
02/10/2015
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