Individual
MALLORY VINCENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
115 NEWSHIRE DR, BROUSSARD, LA 70518-4987
(337) 534-8978
Mailing address
115 NEWSHIRE DR, BROUSSARD, LA 70518-4987
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
328058
LA
225X00000X
Occupational Therapist
—
LA
Other
Enumeration date
07/15/2021
Last updated
05/27/2025
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