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NPI Code Detail

MEDICARE: MALLORY DANIEL

MEDICARE: MALLORY DANIEL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist4333OK

General Provider Information

NPI Number : 1811387269
Entity Type Code : Individual
Provider Name (Legal Business Name) : MALLORY DANIEL
Provider Business Mailing Address
First Line : 6905 NW 122ND ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73142-3903
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6905 NW 122ND ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73142-3903
Country : US
Telephone Number : 405-603-6622
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2015
Last Update Date : 01/23/2015

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Directions to “ MALLORY DANIEL ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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