Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dominique Divece, OTA-2347

Individual provider Occupational Therapy Assistant · NPI 1568043263

Dominique Divece, OTA-2347 is an Occupational Therapy Assistant in Eagle, Idaho. Licensed in Idaho. Registered with an NPI since 2021.

Licensed in
ID
In the registry since
2021
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Practice location Address checks out

449 S Fitness Pl
Eagle, ID 83616-6828
Phone: (208) 957-6301
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapy Assistant (primary) Taxonomy 224Z00000X · Licence OTA-2347 (ID)

Record details

NPI number1568043263
Entity typeIndividual (Type 1)
GenderFemale
Credentials OTA-2347
Sole proprietorNo
NPI enumeratedApril 15, 2021
Last updated in NPPESApril 15, 2021
Certification dateApril 15, 2021

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