Provider Demographics
NPI:1427538867
Name:MAHLMAN, CHARITY E (COTA)
Entity Type:Individual
Prefix:MS
First Name:CHARITY
Middle Name:E
Last Name:MAHLMAN
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8609 CURETON CV
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78747-3934
Mailing Address - Country:US
Mailing Address - Phone:737-781-2017
Mailing Address - Fax:
Practice Address - Street 1:503 OLD AUSTIN HWY
Practice Address - Street 2:
Practice Address - City:BASTROP
Practice Address - State:TX
Practice Address - Zip Code:78602-5091
Practice Address - Country:US
Practice Address - Phone:512-321-6220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-15
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX214906224Z00000X
CO0001505224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant