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NPI Code Detail

MEDICARE: MS. MALLORY ANN SMITH OT

MEDICARE: MS. MALLORY ANN SMITH OT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225XP0019XPhysical Rehabilitation Occupational Therapist5493OK

General Provider Information

NPI Number : 1588516751
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MALLORY ANN SMITH OT
Provider Business Mailing Address
First Line : 2658 S YALE AVE
Second Line :
City : TULSA
State : OK
Zip : 74114-4853
Country : US
Telephone Number : 918-441-6568
Fax Number :
Provider Business Practice Location Address
First Line : 1809 E 13TH ST STE 101
Second Line :
City : TULSA
State : OK
Zip : 74104-4419
Country : US
Telephone Number : 918-579-7100
Fax Number : 918-579-7110
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2026
Last Update Date : 02/11/2026

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Directions to “ MS. MALLORY ANN SMITH OT” Practice Location

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