Shali D Dominguez

Individual provider Active NPI Community Health Worker · Torrington, WY

NPI 1215200068 · NPPES record last updated Nov 18, 2016

Key facts

NPI
1215200068
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Worker 172V00000X
Practice address
501 Albany Ave
Torrington, WY 82240-1503
Phone
(307) 532-4091
NPI assigned
Feb 9, 2012
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X Yes

Addresses

Primary practice location

501 Albany Ave
Torrington, WY 82240-1503

Mailing address

501 Albany Ave
Torrington, WY 82240-1503
Phone (307) 532-4091

Other providers in Torrington, WY

All providers in Torrington, WY · Community Health Worker in Wyoming

Sources for this page

Verify at the official NPI Registry.