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

Michelle Lynn Domack, OTA/L

Individual provider Occupational Therapy Assistant · NPI 1467087361

Michelle Lynn Domack, OTA/L is an Occupational Therapy Assistant in Branford, Connecticut. Licensed in Connecticut. Registered with an NPI since 2020.

Licensed in
CT
In the registry since
2020

Practice location Address checks out

189 Alps Rd
Branford, CT 06405-4771
Phone: (203) 315-2615
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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 001534 (CT)

Record details

NPI number1467087361
Entity typeIndividual (Type 1)
GenderFemale
Credentials OTA/L
Sole proprietorNo
NPI enumeratedMarch 11, 2020
Last updated in NPPESMarch 11, 2020
Certification dateMarch 11, 2020

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