Individual
MRS. MALLORY POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
5015 RUSTIC OAK DR, LONGVIEW, TX 75604-8202
(903) 445-4064
(430) 558-5855
Mailing address
5015 RUSTIC OAK DR, LONGVIEW, TX 75604-8202
(903) 445-4064
(430) 558-5855
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
216955
TX
Other
Enumeration date
12/11/2025
Last updated
12/11/2025
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