Most Relevant Information
Provider Data
| NPI Number: | 1003354143 |
| Provider Name: | KRISTEN DOMINGUEZ L/COTA |
| Entity Type: | Individual |
| Taxonomy Code: | 224Z00000X |
| Specialty: | Occupational Therapy Assistant |
| License Number: | OTA.200502 |
Most Important Dates
| Enumeration Date: | 02/09/2017 |
| Last Updated: | 02/09/2017 |
Provider Practice Location
719 SEVERN AVE
METAIRIE
LA
700015150
Practice Location Phone/Fax
| Phone: | 5044309218 |
| Fax: | 5048352821 |
Provider Mailing Location
420 32ND ST
NEW ORLEANS
LA
701241404
Provider Mailing Phone/Fax
| Phone: | 5047236687 |
| Fax: |