Healthcare Provider Details

I. General information

NPI: 1023927100
Provider Name (Legal Business Name): STEPHANIE MAHLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 PINNELL STREET
RIPLEY WV
25271
US

IV. Provider business mailing address

85 OHIO STATE ROUTE 850 #3
GALLIPOLIS OH
45631
US

V. Phone/Fax

Practice location:
  • Phone: 304-373-1605
  • Fax: 304-372-8114
Mailing address:
  • Phone: 740-988-8507
  • Fax: 304-372-8114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number1301
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code225XM0800X
TaxonomyMental Health Occupational Therapist
License Number1301
License Number StateWV
# 3
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number1301
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: