Individual
ALY JEAN LEBLANC-MALLOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
700 BIRCH LN, WAYNESVILLE, MO 65583-2275
(573) 774-6456
Mailing address
16 SIERRA LN, MADISON, ME 04950-3928
(207) 399-7648
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT4351
ME
Other
Enumeration date
08/29/2023
Last updated
06/04/2024
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