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1124612866
DOMINIQUE A DIAZ
MODESTO, CA
NPI
1124612866
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2021-02-23
Last Update Date
2021-02-23
Business Address
DOMINIQUE A DIAZ
1317 OAKDALE RD STE 610
MODESTO, CA 95355-3365
Phone number: 855-581-0100
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Mailing Address
DOMINIQUE A DIAZ
2080 N TUSTIN AVE STE B
SANTA ANA, CA 92705-7875
Phone number: 855-581-0100
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