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Organization

DOM THE OT LLC

Active
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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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