Individual
ZORAIDA SOFIA DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1951 STELLA LAKE ST STE 36, LAS VEGAS, NV 89106-2144
(702) 595-1415
Mailing address
652 MACCABE AVE, LAS VEGAS, NV 89123-6234
(702) 861-7991
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
1704551333
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1704551333
—
NV
Enumeration date
02/14/2018
Last updated
02/14/2018
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