Individual
MS. MALLORY WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
4626 NEW ROSE AVE, PORTSMOUTH, OH 45662-6517
(740) 876-9086
Mailing address
4626 NEW ROSE AVE, PORTSMOUTH, OH 45662-6517
(740) 876-9086
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA.06318
OH
Other
Enumeration date
10/20/2015
Last updated
10/20/2015
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