Individual
MALLORY HALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3119 W FAIDLEY AVE, GRAND ISLAND, NE 68803-4114
(308) 384-2333
Mailing address
1148 RENAE LN, HASTINGS, NE 68901-6815
(308) 546-7989
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1085
NE
Other
Enumeration date
01/23/2023
Last updated
01/23/2023
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