Provider Demographics
NPI:1750539136
Name:DOMINGUE, APRIL FOREMAN (LOTR)
Entity type:Individual
Prefix:MRS
First Name:APRIL
Middle Name:FOREMAN
Last Name:DOMINGUE
Suffix:
Gender:F
Credentials:LOTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 PARDREW LN
Mailing Address - Street 2:
Mailing Address - City:SCOTT
Mailing Address - State:LA
Mailing Address - Zip Code:70583-4200
Mailing Address - Country:US
Mailing Address - Phone:337-896-2802
Mailing Address - Fax:337-896-2802
Practice Address - Street 1:100 WILLIAM O STUTES ST
Practice Address - Street 2:SUITE A
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-7211
Practice Address - Country:US
Practice Address - Phone:337-406-0712
Practice Address - Fax:337-406-0715
Is Sole Proprietor?:No
Enumeration Date:2008-08-28
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAOTT.Z12223225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist