Provider Demographics
NPI:1194241737
Name:DOMINGUEZ CHANG, NAYI
Entity type:Individual
Prefix:
First Name:NAYI
Middle Name:
Last Name:DOMINGUEZ CHANG
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26655 SW 142ND AVE APT 118
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-5451
Mailing Address - Country:US
Mailing Address - Phone:786-328-3252
Mailing Address - Fax:
Practice Address - Street 1:26655 SW 142ND AVE APT 118
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-5451
Practice Address - Country:US
Practice Address - Phone:786-328-3252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-15
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician