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Elizabeth Diane Dominguez
Student in an Organized Health Care Education/Training Program in Wauwatosa, Wisconsin
NPI 1003506007

Elizabeth Diane Dominguez is a Student in an Organized Health Care Education/Training Program based in Wauwatosa, WI. Elizabeth Diane Dominguez practices in Wauwatosa, WI. The NPI Number for Elizabeth Diane Dominguez is 1003506007 and holds a License No. (Wisconsin).

The current practice location address for Elizabeth Diane Dominguez is 9200 W Wisconsin Ave, Wauwatosa, WI and can be reached out via phone at 414-805-0505.

Location: 9200 W Wisconsin Ave, Wauwatosa, WI, 53226-3522
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1003506007
Provider Name
Elizabeth Diane Dominguez
Credential
Provider Entity Type
Individual
Gender
Female
Address
9200 W Wisconsin Ave, Wauwatosa, WI, 53226-3522
Phone Number
414-805-0505
Fax Number
Provider Enumeration Date
05/11/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
9200 W Wisconsin Ave
City
Wauwatosa
State
Wisconsin
Zip
53226-3522
Phone Number
414-805-0505
Fax Number
person
Provider Business Mailing Address Details
Address
9200 W Wisconsin Ave
City
Wauwatosa
State
Wisconsin
Zip
53226-3522
Phone Number
414-805-0505
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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