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Mallorae Theobald
NPI 1205292422 · on the registry since 2016
Practice
- Address
- 43334 7 Mile Rd
Northville, MI 48167 - Phone
- (517) 898-4868
- Clinicians at this address
- 94
Additional practice sites
- 2400 Science Pkwy, Okemos, MI
Registry record
- Primary taxonomy
- 103K00000X
103K00000X
- Also registered as
- 103K00000X
- Licence states on file
- MI
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2019-09-19
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan