Individual
MS. STEPHANIE DAWN MALLAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3017 N STILES AVE # 200, OKLAHOMA CITY, OK 73105-2811
(405) 795-8591
Mailing address
5601 NORMAN RD, WARR ACRES, OK 73122-7351
(405) 401-4838
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1280
OK
Other
Enumeration date
06/24/2013
Last updated
06/24/2013
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