Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mallory Colleen Bouque

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1023861341

Mallory Colleen Bouque is a Student in an Organized Health Care Education/Training Program in Garfield Heights, Ohio. Practices as a sole proprietor and works from 2 locations. Registered with an NPI since 2024.

In the registry since
2024

Practice location Address checks out

13201 Granger Rd
Garfield Heights, OH 44125-1978
Phone: (248) 464-3927
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

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

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1023861341
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedApril 8, 2024
Last updated in NPPESSeptember 3, 2024
Certification dateSeptember 3, 2024
Mailing address13201 Granger Rd, Garfield Heights, OH 44125-1978

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