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

Individual provider Occupational Therapist · NPI 1598372187

Marykelly Wallace, MOTR/L is an Occupational Therapist in Dearborn, Michigan. Licensed in Michigan. Registered with an NPI since 2020.

Licensed in
MI
In the registry since
2020
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Practice location Address checks out

1 Parklane Blvd Ste 200
Dearborn, MI 48126-4221
Phone: (313) 846-2606
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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 5201010849 (MI)

Record details

NPI number1598372187
Entity typeIndividual (Type 1)
GenderFemale
Credentials MOTR/L
Sole proprietorNo
NPI enumeratedSeptember 28, 2020
Last updated in NPPESFebruary 14, 2025
Certification dateFebruary 14, 2025

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