Mimi Lynn Mallo
Occupational Therapist - Gerontology
517 S Erie St
Three Rivers
, Michigan 49093-2029
Mimi Lynn Mallo
Occupational Therapist - Gerontology
517 S Erie St
Three Rivers
, Michigan 49093-2029
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About
Features
Specialties
- Occupational Therapist - Gerontology
Languages spoken
- English
Location
First Address
- Mimi Lynn Mallo
- 517 S Erie St
- Three Rivers, MI
- Zip : 49093-2029
- Phone :
Second Address
- Mimi Lynn Mallo
- 517 S Erie St
- Three Rivers, MI
- Zip : 49093-2029
- Phone : (269) 273-8661
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 225XG0600X | Occupational Therapist - Gerontology | 5201003014 | MI |
National Provider Identifier
| NPI | 1255802534 |
|---|---|
| Provider Name | Mimi Lynn Mallo |
| First Address | Three Rivers, MI 49093-2029 |
| Second Address | Three Rivers, MI 49093-2029 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/12/2018 |
| Last Update Date | 11/12/2018 |
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.