Individual
MALLORY MATHIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
405 LAUREL ST, NASHVILLE, GA 31639-3030
(229) 543-2602
Mailing address
606 ROSE CIR, NASHVILLE, GA 31639-2721
(229) 237-9656
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA002738
GA
Other
Enumeration date
08/16/2021
Last updated
08/16/2021
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