Individual
CHEYENNE MALLOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1601 CONGRESS ST, PORTLAND, ME 04102-2102
(207) 774-5710
Mailing address
1601 CONGRESS ST, PORTLAND, ME 04102-2102
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT4691
ME
Other
Enumeration date
07/29/2024
Last updated
07/29/2024
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