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Individual

MALLORY DENMARK HALTERMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MHS, OTR/L

Contact information

Practice address
3648 WALTON WAY EXT, AUGUSTA, GA 30909-6660
(706) 434-0799
Mailing address
302 BASTON RD, MARTINEZ, GA 30907-2906
(706) 447-8700
(706) 447-8701

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT005319
GA

Other

Enumeration date
09/21/2011
Last updated
08/25/2021
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