Individual provider · Type 1 NPI

McKenzie Mallard

Developmental Therapist · Bourbonnais, IL

NPI number 1174065080 Active

Practice location

598 Spring Park Loop
Bourbonnais, IL 60914-4968

Call (815) 671-7092 Map

Other practice locations

  • 500 Fairway Dr, Suite 102, Deerfield Beach, FL 33441-1814 · (888) 880-9270

Specialties and licenses

TaxonomyCodeLicense
Developmental Therapist Primary 222Q00000XNone listed

Developmental Therapist: A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Deve…

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About NPI 1174065080

McKenzie Mallard's National Provider Identifier is 1174065080, issued on Nov 9, 2016. The primary taxonomy on file is Developmental Therapist (222Q00000X), and the practice location is in Bourbonnais, IL. The record was last updated on Aug 12, 2019.