Most Relevant Information
Provider Data
| NPI Number: | 1003539206 |
| Provider Name: | DOMINIQUE RODRIGUEZ |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/22/2022 |
| Last Updated: | 09/22/2022 |
Provider Practice Location
1515 W 190TH ST STE 300
GARDENA
CA
902484925
Practice Location Phone/Fax
| Phone: | 3108194523 |
| Fax: |
Provider Mailing Location
1515 W 190TH ST STE 300
GARDENA
CA
902484925
Provider Mailing Phone/Fax
| Phone: | 3108194523 |
| Fax: |