Hannah Jean Mendez Dominguez

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

2005032610 Issued in MO

Practice address

801 Brim St
Desloge, MO 63601-3441

Phone

(573) 431-0223

NPI assigned

Feb 22, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053446195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MAPLE VALLEY DR",
            "address_2": "APT 6",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636401979",
            "telephone_number": "417-434-1344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 BRIM ST",
            "city": "DESLOGE",
            "state": "MO",
            "postal_code": "636013441",
            "telephone_number": "573-431-0223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "HANNAH JEAN",
        "middle_name": "MENDEZ",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2005032610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daleco, Inc. (USA Drug #7638)
• Madison Renee Davis, COTA/L
• Desloge Chiropractic Health Center, LLC
• Desloge Vision Center Inc
• Brett Dickinson, M.D.
• Nicholas Joseph Dupont, PHARMD
• Eastern Missouri General Services Inc
• Michael Christopher Essmyer, D.C.
• Stephen M Forsythe, DO
• Rebecca S Francis, OTR/L

• Occupational Therapist in Desloge, MO
• Providers in Desloge, MO by specialty
• Occupational Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.