Individual
MRS. KAILEY HOPE MALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1445 E 10TH ST, COOKEVILLE, TN 38501-2017
(931) 372-2567
(931) 372-2572
Mailing address
327 N FERGUSON AVE APT 2, COOKEVILLE, TN 38501-2891
(931) 265-9395
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
7558
TN
Other
Enumeration date
09/18/2023
Last updated
09/18/2023
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