Provider Information for 1710674981
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NATASHA DOMINGUEZ PhD
Sex: Female
NPI: 1710674981
Last Updated: 2024-12-10
Certification Date: 2024-12-10
Certification Date: 2024-12-10
Details
| Name | Value | ||||||||||||||||||||||||
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| NPI | 1710674981 | ||||||||||||||||||||||||
| Enumeration Date | 2023-04-19 | ||||||||||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||||||||||
| Status | Active | ||||||||||||||||||||||||
| Mailing Address | 106 M. EVANS ST. #423 LITTLE RIVER ACADEMY, TX 76554-9998 United States Phone: 832-619-9270 | Fax: | ||||||||||||||||||||||||
| Primary Practice Address | 106 M. EVANS ST. #423 LITTLE RIVER ACADEMY, TX 76554-9998 United States Phone: 832-619-9270 | Fax: | ||||||||||||||||||||||||
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