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1811637630
VIRGEN L DOMINGUEZ
ST AUGUSTINE, FL
NPI
1811637630
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: FL SW12393)
Enumeration Date
2022-03-30
Last Update Date
2023-08-09
Business Address
VIRGEN L DOMINGUEZ LCSW
100 DEERFIELD PRESERVE BLVD
ST AUGUSTINE, FL 32086-5966
Phone number: 904-829-0814
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Mailing Address
VIRGEN L DOMINGUEZ LCSW
100 DEERFIELD PRESERVE BLVD
ST AUGUSTINE, FL 32086-5966
Phone number: 904-829-0814
Copy
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