Doctor Name: | MS. MARY DOMHAN |
NPI Number: | 1033418645 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | COTA |
License Number: | 007151-1 |
Business Practice Address: | 1325 Chestnut Hill Dr Wylie, TX - 750986662 |
Business Phone Number: | 6315659698 |
Business Fax Number: | |
Mailing Address: | 302 N Fulton Ave, LINDENHURST |
State: | NY |
Postal Code: | 117573856 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 03/22/2011 |
NPI Last Update Date: | 03/22/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 171W00000X |
License Number: | 007151-1 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NY |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Contractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering). |