Organization
DOMINO EFFECTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINE WATKINS (SECRETARY)
(310) 796-6456
Entity
Organization
Contact information
Practice address
12650 N BEACH ST, FORT WORTH, TX 76244-4256
(817) 618-2212
Mailing address
12650 N BEACH ST, FORT WORTH, TX 76244-4256
(817) 618-2212
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
07/14/2025
Last updated
07/14/2025
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