Provider Demographics
NPI:1811307200
Name:VUONG, MALORIE (MS, OTR)
Entity type:Individual
Prefix:
First Name:MALORIE
Middle Name:
Last Name:VUONG
Suffix:
Gender:F
Credentials:MS, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7935 E PRENTICE AVE
Mailing Address - Street 2:#104
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2708
Mailing Address - Country:US
Mailing Address - Phone:303-756-0280
Mailing Address - Fax:
Practice Address - Street 1:7935 E PRENTICE AVE
Practice Address - Street 2:#104
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2708
Practice Address - Country:US
Practice Address - Phone:303-756-0280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-06
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0003972390200000X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program