Individual
LYDIA DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1730 HARRISON AVE APT 1E, BRONX, NY 10453-8401
(929) 220-6579
Mailing address
1730 HARRISON AVE APT 1E, BRONX, NY 10453-8401
(929) 220-6579
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
04/24/2025
Last updated
04/24/2025
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