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: |