Individual
MALLORY NICHOLE SHOUKLETOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. OTR/L
Contact information
Practice address
3131 TOM AUSTIN HWY, SPRINGFIELD, TN 37172-4801
(615) 382-7979
Mailing address
1240 HILLWOOD PRIVATE CV, NASHVILLE, TN 37209-2640
(618) 889-2212
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
05/28/2019
Last updated
05/28/2019
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