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General NPI Number Information
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NPI Number | 1558783001
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Entity Type | Organization
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Legal Business Name | DORIS M. DOMINGUEZ, MSW,LCSW,PA
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Dates
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Enumeration Date | 01/16/2014
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Last Update Date | 01/16/2014
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Provider Practice Location Address
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Address Line | 9010 SW 137 AVE 236
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City | MIAMI
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State | FL
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Zip | 33186-1408
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Country | US
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Telephone | 305-772-9681
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Fax | 888-505-1224
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Provider Business Mailing Address
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Address Line | 9010 SW 137 AVE 236
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City | MIAMI
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State | FL
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Zip | 33186-1408
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Country | US
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Telephone | 305-772-9681
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Fax | 888-505-1224
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Authorized Official
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Title or Position | PSYCHOTHERAPIST
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Name | DORIS M DOMINGUEZ
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Credential | LCSW
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Telephone | 305-772-9681
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW 7555
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License Number State | FL
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