Individual
TAMMY MALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.O.T.A
Contact information
Practice address
701 OLYMPIC PLAZA CIR, TYLER, TX 75701-1950
(903) 596-3161
Mailing address
701 OLYMPIC PLAZA CIR, TYLER, TX 75701-1950
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
208688
TX
Other
Enumeration date
03/17/2020
Last updated
03/17/2020
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