Dominique Divece, OTA-2347 Valid NPI

Individual provider · Occupational Therapy Assistant · Eagle, ID

NPI

1568043263

Type

Individual (Type 1)

Primary specialty

Occupational Therapy Assistant

Specialty group

Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy code

224Z00000X

License number

OTA-2347 (ID)

Sex

Female

Sole proprietor

No

Enumerated

2021-04-15

Last updated

2021-04-15