Individual
GINA ANNE MALITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOT, OTRL
Contact information
Practice address
1377 11TH ST NW, CLINTON, IA 52732-5068
(563) 241-4230
(563) 241-4235
Mailing address
1312 W 38TH PL, DAVENPORT, IA 52806-5503
(563) 940-4710
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
001832
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0665711
—
IA
01
—
58204
BLUE CROSS BLUE SHIELD
IA
01
—
I20672
MEDICARE
IA
Enumeration date
06/27/2007
Last updated
12/27/2007
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