Individual
MALLORY NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
118 MEDICAL DR, CARMEL, IN 46032-3323
(317) 483-4590
Mailing address
141 E 75TH ST, ANDERSON, IN 46013-3901
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32003391A
IN
224Z00000X
Occupational Therapy Assistant
—
—
Other
Enumeration date
01/17/2023
Last updated
01/17/2023
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