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Individual

HANNAH JOSEPHINE MALLETS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1 MEMORIAL DR, ALTON, IL 62002-6722
(618) 463-7330
Mailing address
1 MEMORIAL DR, ALTON, IL 62002-6722
(618) 463-7330

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.012573
IL
225X00000X
Occupational Therapist
2018026618
MO

Other

Enumeration date
09/12/2018
Last updated
09/12/2018
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