Individual
MISS MALLORY YVONNE KOVAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
25 ADAMS RD, WILLIAMSTOWN, MA 01267-2928
(413) 458-2111
Mailing address
97 BUTTON RD, WATERFORD, NY 12188-1211
(518) 698-4548
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
009348-1
NY
Other
Enumeration date
07/23/2017
Last updated
07/23/2017
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