Individual
VICKI SUE MALLORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
100 POWELL DR, DUNDEE, MI 48131-8644
(517) 266-1481
Mailing address
100 POWELL DR, DUNDEE, MI 48131-8644
(517) 266-1481
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202006867
MI
224Z00000X
Occupational Therapy Assistant
OTA001657
OH
Other
Enumeration date
01/15/2021
Last updated
01/15/2021
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