Provider Demographics
NPI:1588100317
Name:APEL, MALLORY
Entity type:Individual
Prefix:
First Name:MALLORY
Middle Name:
Last Name:APEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 ELMSHADE LN
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-7420
Mailing Address - Country:US
Mailing Address - Phone:419-787-0202
Mailing Address - Fax:
Practice Address - Street 1:1008 ELMSHADE LN
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-7420
Practice Address - Country:US
Practice Address - Phone:419-787-0202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-18
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5576225X00000X
TX116176225X00000X
OR324280225X00000X
MD07368225X00000X
WAOT60595314225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist