Healthcare Provider Details

I. General information

NPI: 1629904560
Provider Name (Legal Business Name): MALIK D HYATT, OTD, OTR/L OTD, OTR/L
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 E 9TH ST
RENO NV
89512-2800
US

IV. Provider business mailing address

110 RIVER ROCK ST APT 418
RENO NV
89501
US

V. Phone/Fax

Practice location:
  • Phone: 775-348-0200
  • Fax:
Mailing address:
  • Phone: 980-251-2464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT-3705
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: