Individual
KRISTEN DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L/COTA
Contact information
Practice address
719 SEVERN AVE, METAIRIE, LA 70001-5150
(504) 430-9218
(504) 835-2821
Mailing address
420 32ND ST, NEW ORLEANS, LA 70124-1404
(504) 723-6687
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA.200502
LA
Other
Enumeration date
02/09/2017
Last updated
02/09/2017
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