Provider Demographics
NPI:1447041058
Name:CUELLAR, DOMINIQUE HOPE (NCC, LPC-A)
Entity type:Individual
Prefix:
First Name:DOMINIQUE
Middle Name:HOPE
Last Name:CUELLAR
Suffix:
Gender:F
Credentials:NCC, LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 ENNIS JOSLIN RD APT 524
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78412-4376
Mailing Address - Country:US
Mailing Address - Phone:512-906-8718
Mailing Address - Fax:
Practice Address - Street 1:1701 ENNIS JOSLIN RD APT 524
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78412-4376
Practice Address - Country:US
Practice Address - Phone:512-906-8178
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health