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

Mr. Andre Divine Domingos

Individual provider Occupational Therapy Assistant · NPI 1356798128

Mr. Andre Divine Domingos is an Occupational Therapy Assistant in Olney, Maryland. Practices as a sole proprietor. Licensed in Maryland.

Licensed in
MD
In the registry since
2016

Practice location Address checks out

17420 Gallagher Way
Olney, MD 20832-2059
Phone: (240) 377-1700
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapy Assistant (primary) Taxonomy 224Z00000X · Licence A02204 (MD)

Record details

NPI number1356798128
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMay 20, 2016
Last updated in NPPESMay 20, 2016
Mailing address17420 Gallagher Way, Olney, MD 20832-2059

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