Individual
MALLORY JO MAYE MUNDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3300 36TH ST SE, GRAND RAPIDS, MI 49512-2810
(616) 942-2110
Mailing address
3048 ROCKTON CIR, HUDSONVILLE, MI 49426-7602
(616) 283-0564
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202010211
MI
Other
Enumeration date
09/03/2024
Last updated
03/26/2025
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