Individual
JENNIFER MALLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1350 S SUNNY SLOPE RD, BROOKFIELD, WI 53005-7060
(414) 805-9600
(414) 805-9645
Mailing address
1350 S SUNNY SLOPE RD, BROOKFIELD, WI 53005-7060
(414) 805-9600
(414) 805-9645
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0756
WI
Other
Enumeration date
05/14/2015
Last updated
05/14/2015
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