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General NPI Number Information
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NPI Number | 1578266292
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Entity Type | Individual
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Provider Name | MALLORY RATZ OTR/L
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Gender | Female
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Dates
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Enumeration Date | 03/22/2023
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Last Update Date | 03/22/2023
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Provider Practice Location Address
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Address Line | 1075 WASHINGTON BLVD
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City | ROBBINSVILLE
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State | NJ
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Zip | 08691-3119
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Country | US
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Telephone | 701-732-3709
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Fax |
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Provider Business Mailing Address
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Address Line | 1320 PATRIOT WAY
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City | EASTAMPTON
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State | NJ
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Zip | 08060-9702
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Country | US
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Telephone | 551-587-0297
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Fax |
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 46TR01099700
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License Number State | NJ
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