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Individual

JOLENE DOMYAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
151 VICTORIA COMMONS BLVD STE 107, DELAND, FL 32724-7722
(386) 943-4690
Mailing address
401 W SEMINOLE BLVD APT 159, SANFORD, FL 32771-7802

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary

Other

Enumeration date
03/17/2020
Last updated
03/17/2020
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