Individual
KELLY ANN MALLOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2810 AMBASSADOR CAFFERY PKWY, LAFAYETTE, LA 70506-5906
(337) 989-6797
(337) 989-6759
Mailing address
114 RIVERBIRCH DR, LAFAYETTE, LA 70508-1819
(337) 950-1317
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA200055
LA
Other
Enumeration date
05/07/2009
Last updated
05/07/2009
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