| NPI | 1245908771 |
|---|---|
| Former Name | MALLORY TAYLOR KOLLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: MN 106653) |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-08-31 |
| Last Update Date | 2025-06-24 |