| Doctor Name: | RITA DOMINGUEZ |
| NPI Number: | 1265625156 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | B-2391 |
| Business Practice Address: | 1301 West Washington Street Anthony, NM - 88021 |
| Business Phone Number: | 5058826200 |
| Business Fax Number: | 5058826280 |
| Mailing Address: | P.o. Drawer 70, ANTHONY |
| State: | NM |
| Postal Code: | 88021 |
| Phone Number: | 5758826101 |
| Fax Number: | 5758826926 |
| NPI Enumeration Date: | 08/23/2007 |
| NPI Last Update Date: | 01/08/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YS0200X |
| License Number: | B-2391 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NM |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |