Provider Demographics
NPI:1851728562
Name:PLEIMAN, MALLORY RENEE (OTR/L)
Entity Type:Individual
Prefix:
First Name:MALLORY
Middle Name:RENEE
Last Name:PLEIMAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 SIOUX ST
Mailing Address - Street 2:
Mailing Address - City:FORT LORAMIE
Mailing Address - State:OH
Mailing Address - Zip Code:45845-9315
Mailing Address - Country:US
Mailing Address - Phone:937-726-7186
Mailing Address - Fax:
Practice Address - Street 1:375 SIOUX ST
Practice Address - Street 2:
Practice Address - City:FORT LORAMIE
Practice Address - State:OH
Practice Address - Zip Code:45845-9315
Practice Address - Country:US
Practice Address - Phone:937-726-7186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-27
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT.008273225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist