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1043518046
ROSE MARY MEDINA-DOMINGUEZ
TAOS, NM
NPI
1043518046
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: NM C-08749)
Enumeration Date
2011-03-01
Last Update Date
2024-02-05
Business Address
Mrs. ROSE MARY MEDINA-DOMINGUEZ LCSW
105 BERTHA RD STE B
TAOS, NM 87571-7148
Phone number: 575-758-4297
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Mailing Address
Mrs. ROSE MARY MEDINA-DOMINGUEZ LCSW
PO BOX 36
CHAMISAL, NM 87521-0036
Phone number: 505-659-8769
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