National Provider Identifier
Dominique Latoya Prophet, COTA
Dominique Latoya Prophet, COTA is listed in the NPPES registry with a primary specialty of Pediatric Occupational Therapist in Kenmore, NY and a listed phone number of (716) 874-6175.
Profile Overview
- NPI
- 1447096656
- Provider Type
- Individual
- Primary Specialty
- Pediatric Occupational Therapist
- Enumeration Date
- July 08, 2024
- Last Updated
- July 08, 2024
Practice Location
- 3767 Delaware Ave
- Kenmore, NY 14217-1040
Phone: (716) 874-6175
Mailing Address
- 227 Vine Ln
- Buffalo, NY 14228-1845
Specialties
- Pediatric Occupational Therapist (225XP0200X)
Full Record
- NPI
- 1447096656
- Entity Type
- Individual
- Last Name
- Prophet
- First Name
- Dominique
- Middle Name
- Latoya
- Credential
- COTA
- Mailing Street Address
- 227 Vine Ln
- Mailing City
- Buffalo
- Mailing State
- NY
- Mailing ZIP Code
- 14228-1845
- Mailing Country
- US
- Mailing Phone
- (716) 544-8758
- Practice Street Address
- 3767 Delaware Ave
- Practice City
- Kenmore
- Practice State
- NY
- Practice ZIP Code
- 14217-1040
- Practice Country
- US
- Practice Phone
- (716) 874-6175
- Enumeration Date
- July 08, 2024
- Last Updated
- July 08, 2024
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- July 07, 2024
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Pediatric Occupational Therapist (225XP0200X)