Individual
MALLORY IMOBERSTEG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
220 RIDGE AVE, PLATTEVILLE, WI 53818-1146
(608) 732-0312
Mailing address
220 RIDGE AVE, PLATTEVILLE, WI 53818-1146
(608) 732-0312
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
07/09/2018
Last updated
02/15/2024
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