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Individual

SERGIO DOMINGUEZ JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
7818 BIG SKY DR STE 214, MADISON, WI 53719-2840
(708) 887-3994
Mailing address
7818 BIG SKY DR STE 214, MADISON, WI 53719-2840

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
5492-57
WI
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
01/10/2022
Last updated
01/20/2026
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