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1194265249
RAQUEL DESIREE MALLETT
KANSAS CITY, MO
NPI
1194265249
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: MO 2016043316)
Enumeration Date
2017-03-07
Last Update Date
2017-03-07
Business Address
RAQUEL DESIREE MALLETT
8559 N LINE CREEK PKWY
KANSAS CITY, MO 64154-2100
Phone number: 816-468-2011
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Mailing Address
RAQUEL DESIREE MALLETT
10908 W 66TH ST APT 303
SHAWNEE, KS 66203-3425
Phone number: 816-315-6583
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