Provider Demographics
NPI:1508905415
Name:MALLOY, LINDA ARLENE (OT)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:ARLENE
Last Name:MALLOY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2317 ASH ST
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-0506
Mailing Address - Country:US
Mailing Address - Phone:406-256-3606
Mailing Address - Fax:
Practice Address - Street 1:2802 13TH ST W
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-1705
Practice Address - Country:US
Practice Address - Phone:406-247-3800
Practice Address - Fax:406-245-1149
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT50225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics