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1013758614
MALLORY WINE
LITTLE ROCK, AR
NPI
1013758614
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
235Z00000X Speech-Language Pathologist
(Licence: AR 202687)
Enumeration Date
2024-06-05
Last Update Date
2024-06-05
Business Address
MALLORY WINE CF, SLP
824 N TYLER ST
LITTLE ROCK, AR 72205-3535
Phone number: 501-664-2961
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Mailing Address
MALLORY WINE CF, SLP
13819 IRONTON CUT OFF RD
LITTLE ROCK, AR 72206-5279
Phone number: 501-765-2881
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