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Individual

MRS. JENNY DORRIS DOMIANO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MOT, OTR/L

Contact information

Practice address
1817 CLEARY AVE, METAIRIE, LA 70001-2625
(504) 831-2321
(504) 831-8388
Mailing address
1817 CLEARY AVE, METAIRIE, LA 70001-2625
(504) 831-2321
(504) 831-8388

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OTT.Z11942
LA

Other

Enumeration date
03/19/2010
Last updated
03/19/2010
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