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

Mallory Lee Gardner

Individual provider Occupational Therapy Assistant · NPI 1558038810

Mallory Lee Gardner is an Occupational Therapy Assistant in Desloge, Missouri. Licensed in Missouri. Registered with an NPI since 2021.

Licensed in
MO
In the registry since
2021

Practice location Address checks out

801 Brim St
Desloge, MO 63601-3441
Phone: (573) 431-0023
Show map & directions

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

Specialties & licences

Occupational Therapy Assistant (primary) Taxonomy 224Z00000X · Licence 2017001953 (MO)

Record details

NPI number1558038810
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 25, 2021
Last updated in NPPESAugust 25, 2021
Certification dateAugust 25, 2021
Mailing address10637 Hopewell Rd., Mineral Point, MO 63660

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