Provider Demographics
NPI:1295481638
Name:MCLARNON, MYKALA (OTR/L)
Entity type:Individual
Prefix:
First Name:MYKALA
Middle Name:
Last Name:MCLARNON
Suffix:
Gender:
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 1:234B DERRY HILL CT
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-3709
Mailing Address - Country:US
Mailing Address - Phone:908-477-0876
Mailing Address - Fax:
Practice Address - Street 1:20 PIONEER BLVD
Practice Address - Street 2:
Practice Address - City:WESTAMPTON
Practice Address - State:NJ
Practice Address - Zip Code:08060-3824
Practice Address - Country:US
Practice Address - Phone:609-261-5600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-24
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR01043900225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist