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1053705806
MALLORY CHILDRESS
AVONDALE, AZ
NPI
1053705806
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Former Name
MALLORY WALTENBURG
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: AZ 5379)
Enumeration Date
2015-03-18
Last Update Date
2015-03-18
Business Address
-- MALLORY CHILDRESS COTA/L, B.I.S.
12550 W PALM LN
AVONDALE, AZ 85392-6594
Phone number: 623-824-2147
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Mailing Address
-- MALLORY CHILDRESS COTA/L, B.I.S.
12550 W PALM LN
AVONDALE, AZ 85392-6594
Phone number: 623-824-2147
Copy
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