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

17420 Gallagher Way
Olney, MD 20832-2059
Phone: (240) 377-1700
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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 A02204 (MD)

Record details

NPI number1356798128
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMay 20, 2016
Last updated in NPPESMay 20, 2016

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