Provider Demographics
NPI:1396168746
Name:MALLOY, RORY O'CHRISTENSEN (MA CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:RORY
Middle Name:O'CHRISTENSEN
Last Name:MALLOY
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7 E BRANCH DR
Mailing Address - Street 2:
Mailing Address - City:ALFRED
Mailing Address - State:ME
Mailing Address - Zip Code:04002-3372
Mailing Address - Country:US
Mailing Address - Phone:781-710-0328
Mailing Address - Fax:
Practice Address - Street 1:29 SEA RD
Practice Address - Street 2:
Practice Address - City:KENNEBUNK
Practice Address - State:ME
Practice Address - Zip Code:04043-7214
Practice Address - Country:US
Practice Address - Phone:207-985-1105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-21
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8561235Z00000X
MESP2521235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MESP2521OtherSTATE OF MAINE BOARD OF SPEECH, AUDIOLOGY AND HEARING
MA14049753OtherAMERICAN SPEECH-LANGUAGE HEARING ASSOCIATION (ASHA)