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1134655640
LARRY MALLORY
COLUMBUS, OH
NPI
1134655640
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OH 976259)
Enumeration Date
2017-05-03
Last Update Date
2017-05-03
Business Address
-- LARRY MALLORY LCDCII
1515 E BROAD ST
COLUMBUS, OH 43205-1550
Phone number: 614-251-0711
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Mailing Address
-- LARRY MALLORY LCDCII
9902 HOOVER WOODS RD
GALENA, OH 43021-9482
Phone number: 740-815-4739
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