Individual provider · Type 1 NPI

Mallory Colleen Bouque

Student in an Organized Health Care Education/Training Program · Garfield Heights, OH

NPI number 1023861341 Active

Practice location

13201 Granger Rd
Garfield Heights, OH 44125-1978

Call (248) 464-3927 Map

Other practice locations

  • 11235 Bellflower Rd, Cleveland, OH 44106-3932 · (248) 464-3927

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1023861341

Mallory Colleen Bouque's National Provider Identifier is 1023861341, issued on Apr 8, 2024. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Garfield Heights, OH. The record was last updated on Sep 3, 2024.