Individual
SANDRA S DOMAGALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
900 E BROADWAY AVE, BISMARCK, ND 58501
(701) 530-7000
(701) 530-8842
Mailing address
900 E BROADWAY AVE, P.O. BOX 5510, BISMARCK, ND 58506-5510
(701) 530-7000
(701) 530-8842
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
460
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
460
LICENSE
ND
Enumeration date
01/23/2008
Last updated
01/23/2008
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