| Doctor Name: | KRISTINE M DOMINO |
| NPI Number: | 1124125893 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | SLP |
| License Number: | 2739 |
| Business Practice Address: | 2300 Menaul Blvd Ne Albuquerque, NM - 871071851 |
| Business Phone Number: | 5052720322 |
| Business Fax Number: | 5052722014 |
| Mailing Address: | 933 Bradbury Dr Se, Suite 2222 ALBUQUERQUE |
| State: | NM |
| Postal Code: | 871064374 |
| Phone Number: | 5052723120 |
| Fax Number: | 5052728060 |
| NPI Enumeration Date: | 09/17/2006 |
| NPI Last Update Date: | 03/15/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 2739 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |