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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

JENICA E DOMANICO, MA, OTR/L

Active

JENICA E DOMANICO, MA, OTR/L is a Pediatric Occupational Therapist healthcare provider located in WHITE BEAR LAKE, Minnesota. NPI 1679829899 is currently active in the NPPES registry. Verify at CMS.

Pediatric Occupational Therapist · WHITE BEAR LAKE, MN

Registration Details

NPI Number
1679829899
Provider Type
Individual
Gender
Female
NPI Issued
Jul 25, 2012 (14.019068550274 yrs)
Last Updated
Dec 13, 2018
License
104260 (MN)

Practice Information

Address
5842 HOBE LN
WHITE BEAR LAKE, MN, 551106477
Browse MN providers · Browse ZIP 55110
Phone
6513831197
Primary Specialty
Pediatric Occupational Therapist
225XP0200X

Other Pediatric Occupational Therapist Providers in WHITE BEAR LAKE, MN

Name Credential NPI
JENNIFER MARIE FRISON OTR/L 1578875142
HANNAH ROSE STEGORA 1437656113
MIA ROSE MASSARO 1518525906
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.