Individual
VITALINO ROSENDO DOMINGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BA, SW
Contact information
Practice address
900 BEASLEY ST, LEXINGTON, KY 40509-4266
(859) 254-1035
Mailing address
3105 SANDERSVILLE RD, LEXINGTON, KY 40511-8894
(270) 313-5881
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
08/30/2016
Last updated
08/30/2016
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