Individual
KARLEEN GRACE DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1302 W 25TH AVE, ANCHORAGE, AK 99503-1628
(907) 301-0228
Mailing address
PO BOX 240661, ANCHORAGE, AK 99524-0661
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
AK
Other
Enumeration date
04/28/2017
Last updated
04/28/2017
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