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1174679153
MARY ELLEN MALLOY
BROOKFIELD, WI
NPI
1174679153
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: WI 1191)
Enumeration Date
2007-01-25
Last Update Date
2007-07-08
Business Address
-- MARY ELLEN MALLOY OT
17280 W NORTH AVE 104
BROOKFIELD, WI 53045-4366
Phone number: 262-780-0707
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Mailing Address
-- MARY ELLEN MALLOY OT
17280 W NORTH AVE 104
BROOKFIELD, WI 53045-4366
Phone number: 262-780-0707
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