Individual
DOMINGA ANTONIO NOLASCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AAC
Contact information
Practice address
627 W FRANKLIN ST, SHELTON, WA 98584-3504
(360) 763-5610
Mailing address
627 W FRANKLIN ST, SHELTON, WA 98584-3504
(360) 763-5610
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/05/2025
Last updated
02/05/2025
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