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1528690773
MARC ADRIAN DOMINGUEZ
CALDWELL, ID
NPI
1528690773
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: ID LCSW-42533)
Enumeration Date
2020-02-06
Last Update Date
2023-06-15
Business Address
MARC ADRIAN DOMINGUEZ LCSW
3110 CLEVELAND BLVD STE D
CALDWELL, ID 83605-5539
Phone number: 208-614-6752
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Mailing Address
MARC ADRIAN DOMINGUEZ LCSW
3110 CLEVELAND BLVD STE D
CALDWELL, ID 83605-5539
Phone number: 208-614-6752
Copy
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