Individual
CAROLINA DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1708 WALDEN LN, WEST PALM BEACH, FL 33406-5631
(703) 342-2346
Mailing address
1708 WALDEN LN, WEST PALM BEACH, FL 33406-5631
(703) 342-2346
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
222Q00000X
Developmental Therapist
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
12/29/2014
Last updated
01/26/2021
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