Provider Demographics
NPI:1366336752
Name:MCARTHUR, DOMINIQUE (OTD)
Entity type:Individual
Prefix:MISS
First Name:DOMINIQUE
Middle Name:
Last Name:MCARTHUR
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14334 RIPPY RD
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39503-4720
Mailing Address - Country:US
Mailing Address - Phone:228-343-5509
Mailing Address - Fax:
Practice Address - Street 1:14334 RIPPY RD
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39503-4720
Practice Address - Country:US
Practice Address - Phone:228-343-5509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-09
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSOT-4181225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics