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General NPI Number Information
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NPI Number | 1366704371
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Entity Type | Individual
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Provider Name | SHIRLYN R MALLEY O.T.R
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Gender | Female
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Dates
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Enumeration Date | 06/14/2012
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Last Update Date | 06/14/2012
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Provider Practice Location Address
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Address Line | 264 N WESTWOOD ST
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City | PORTERVILLE
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State | CA
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Zip | 93257-2542
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Country | US
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Telephone | 559-737-3790
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Fax |
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Provider Business Mailing Address
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Address Line | 6347 W JUDY AVE
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City | VISALIA
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State | CA
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Zip | 93277-0814
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Country | US
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Telephone | 559-737-3790
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Fax | 559-735-0873
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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 | 171W00000X
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Taxonomy Name | Contractor
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License Number | 6265
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License Number State | CA
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