Healthcare Provider Details

I. General information

NPI: 1376464784
Provider Name (Legal Business Name): MALLOY O'MALLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4565 HILTON PKWY STE 101
COLORADO SPRINGS CO
80907-3540
US

IV. Provider business mailing address

4565 HILTON PKWY STE 101
COLORADO SPRINGS CO
80907-3540
US

V. Phone/Fax

Practice location:
  • Phone: 720-542-8737
  • Fax: 720-242-8085
Mailing address:
  • Phone: 720-542-8737
  • Fax: 720-242-8085

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP0007046
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: