Individual provider · Type 1 NPI

Dominique Samantha Hallak

Student in an Organized Health Care Education/Training Program · Phoenix, AZ

NPI number 1396697512 Active

Practice location

1010 E Mcdowell Rd Ste 410
Phoenix, AZ 85006-2606

Call (480) 818-9078 Map

Mailing address

21000 E Carriage Way
Queen Creek, AZ 85142-3821

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: 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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About NPI 1396697512

Dominique Samantha Hallak's National Provider Identifier is 1396697512, issued on Feb 11, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Phoenix, AZ. The record was last updated on Feb 11, 2026.