Individual
MARY DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
110 COURT ST STE 3, CROMWELL, CT 06416-1273
(860) 613-9930
Mailing address
113 MILL PLAIN RD # 1018, DANBURY, CT 06811-5277
(203) 213-3108
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-32863
—
Other
Enumeration date
03/20/2019
Last updated
12/26/2024
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