Individual
MALLORY C SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
960 COMMONWEALTH BLVD, TUPELO, MS 38804-3880
(662) 260-3789
(662) 260-3790
Mailing address
1200 CORPORATE DR STE 400, HOOVER, AL 35242-5424
(423) 206-4158
(717) 773-4654
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT3874
MS
Other
Enumeration date
07/27/2021
Last updated
07/27/2021
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