Mallory Tillitt
Occupational Therapist - Gerontology
2417 Valley Rd
Navarre
, Florida 32566-8729
Mallory Tillitt
Occupational Therapist - Gerontology
2417 Valley Rd
Navarre
, Florida 32566-8729
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About
Features
Specialties
- Occupational Therapist - Gerontology
Languages spoken
- English
Location
First Address
- Mallory Tillitt
- 2417 Valley Rd
- Navarre, FL
- Zip : 32566-8729
- Phone :
Second Address
- Mallory Tillitt
- 2417 Valley Rd
- Navarre, FL
- Zip : 32566-8729
- Phone : (850) 607-0115
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 225XG0600X | Occupational Therapist - Gerontology | OT 13494 | FL |
National Provider Identifier
| NPI | 1275939530 |
|---|---|
| Provider Name | Mallory Tillitt |
| First Address | Navarre, FL 32566-8729 |
| Second Address | Navarre, FL 32566-8729 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 14/11/2014 |
| Last Update Date | 14/11/2014 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.