MR. Ricky Dominguez

NPI #1700179355 in Santa Teresa, New Mexico

Provider Information

NPI Number: 1700179355
Entity Type: Individual
Name: MR. Ricky Dominguez
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Behavior Analyst
Enumeration Date: May 16, 2011
Last Updated: May 16, 2011

Practice Location

Address: 5808 WILLET DR
City: Santa Teresa
State: New Mexico
ZIP Code: 88008-9521
Phone: (915) 204-5625

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Analyst	103K00000X	Primary

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