Organization
DOM THE OT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOMINIQUE ALEXIS (OWNER)
(786) 390-6614
Entity
Organization
Contact information
Practice address
5690 ATLANTIC AVE APT 204, DELRAY BEACH, FL 33484-8217
(786) 390-6614
Mailing address
5690 ATLANTIC AVE APT 204, DELRAY BEACH, FL 33484-8217
(786) 390-6614
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
Other
Enumeration date
09/10/2021
Last updated
09/10/2021
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