Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jenica E Domanico, MA, OTR/L

Individual provider Pediatric Occupational Therapist · NPI 1679829899

Jenica E Domanico, MA, OTR/L is a Pediatric Occupational Therapist in White Bear Lake, Minnesota. Licensed in Minnesota. Registered with an NPI since 2012.

Licensed in
MN
In the registry since
2012
What do these letters mean?
MA — Master of Arts
A graduate arts degree.
OTR/L — Occupational Therapist, Registered and Licensed
An occupational therapist who is both nationally registered and state licensed.

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Practice location Address checks out

5842 Hobe Ln
White Bear Lake, MN 55110-6477
Phone: (651) 383-1197
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Occupational Therapist (primary) Taxonomy 225XP0200X · Licence 104260 (MN)

Record details

NPI number1679829899
Entity typeIndividual (Type 1)
GenderFemale
Credentials MA , OTR/L
Sole proprietorNo
NPI enumeratedJuly 25, 2012
Last updated in NPPESDecember 13, 2018

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