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

Individual provider Occupational Therapist · NPI 1164291456

Mallory Serpan Blackburn, OTR/L is an Occupational Therapist in Raleigh, North Carolina. Licensed in North Carolina. Registered with an NPI since 2023.

Licensed in
NC
In the registry since
2023
What do these letters mean?
OTR/L — Occupational Therapist, Registered and Licensed
An occupational therapist who is both nationally registered and state licensed.

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Practice location Address checks out

4201 Lake Boone Trl Ste 4
Raleigh, NC 27607-7511
Phone: (919) 781-4434
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 15745 (NC)

Record details

NPI number1164291456
Entity typeIndividual (Type 1)
GenderFemale
Credentials OTR/L
Sole proprietorNo
NPI enumeratedDecember 27, 2023
Last updated in NPPESMarch 22, 2024
Certification dateMarch 22, 2024

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