DOMINIQUE DIVECE

EAGLE, ID
NPI1568043263
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: ID  ota-2347)
Enumeration Date2021-04-15
Last Update Date2021-04-15
Business Address
DOMINIQUE DIVECE OTA-2347
449 S FITNESS PL
EAGLE, ID 83616-6828
Phone number: 208-957-6301
Mailing Address
DOMINIQUE DIVECE OTA-2347
449 S FITNESS PL
EAGLE, ID 83616-6828
Phone number:
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