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Individual

ASHLEY MARIE DOMINGUEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMHC

Contact information

Practice address
5201 BLUE LAGOON DR # 891, MIAMI, FL 33126
(786) 613-0820
Mailing address
5201 BLUE LAGOON DR # 891, MIAMI, FL 33126-2064
(786) 613-0820

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
15858
FL
101YM0800X
Mental Health Counselor
Primary
MH15858
FL

Other

Enumeration date
01/14/2019
Last updated
06/26/2019
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