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Individual

NISHA MALI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OCCUPATIONAL THERAP

Contact information

Practice address
352 WATFORD DR APT WATFORD, BALLWIN, MO 63011-5022
(314) 662-7538
Mailing address
352 WATFORD DR APT A, BALLWIN, MO 63011-5022
(314) 662-7538

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2019022298
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2019022298
MISSOURI BOARD OF OCCUPATIONAL THERAPY
MO
Enumeration date
01/18/2020
Last updated
08/13/2021
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