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General NPI Number Information
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NPI Number | 1366115123
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Entity Type | Individual
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Provider Name | ALYSSA MAHONEY OTD, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 07/28/2021
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Last Update Date | 09/22/2022
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Provider Practice Location Address
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Address Line | 1780 SHILOH RD STE B
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City | BILLINGS
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State | MT
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Zip | 59106-1736
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Country | US
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Telephone | 406-596-3105
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Fax | 406-656-1713
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Provider Business Mailing Address
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Address Line | 119 W MARYLAND LN
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City | LAUREL
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State | MT
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Zip | 59044-2041
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Country | US
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Telephone | 406-596-3105
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Fax | 406-656-1713
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 8508
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License Number State | MT
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