Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mallory Childress, COTA/L, BIS

Individual provider Occupational Therapy Assistant · NPI 1053705806

Mallory Childress, COTA/L, BIS is an Occupational Therapy Assistant in Avondale, Arizona. Licensed in Arizona. Registered with an NPI since 2015.

Licensed in
AZ
In the registry since
2015
What do these letters mean?
COTA/L — Certified Occupational Therapy Assistant, Licensed
An occupational therapy assistant who is both certified and state licensed.

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Practice location Address checks out

12550 W Palm Ln
Avondale, AZ 85392-6594
Phone: (623) 824-2147
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapy Assistant (primary) Taxonomy 224Z00000X · Licence 5379 (AZ)

Record details

NPI number1053705806
Entity typeIndividual (Type 1)
GenderFemale
Credentials COTA/L , BIS
Sole proprietorNo
NPI enumeratedMarch 18, 2015
Last updated in NPPESMarch 18, 2015

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