Individual
LARISSA DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15215 S 48TH ST STE 145, PHOENIX, AZ 85044-9138
(602) 358-8148
Mailing address
15215 S 48TH ST UNIT 145, PHOENIX, AZ 85044-9142
(602) 358-8148
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
16005
AZ
Other
Enumeration date
06/23/2026
Last updated
06/23/2026
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