Individual
ANA JANETTE DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RMHCI
Contact information
Practice address
833 E OAK ST, KISSIMMEE, FL 34744-5838
(786) 714-3713
Mailing address
2244 VILLA VERANO WAY APT 101, KISSIMMEE, FL 34744-5979
(407) 874-0249
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
IMH20506
FL
Other
Enumeration date
03/10/2021
Last updated
03/10/2021
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