Individual
DIANA DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
228 LAFAYETTE ST FL 2, NEWARK, NJ 07105-1815
(973) 789-8111
Mailing address
91 MAGAZINE ST APT 201, NEWARK, NJ 07105-3428
(732) 632-7430
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SL06212800
NJ
Other
Enumeration date
03/23/2018
Last updated
03/23/2018
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