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1205078086
ODASIA MALLORY
LAWRENCEVILLE, GA
NPI
1205078086
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: GA SLP007676)
Enumeration Date
2009-03-25
Last Update Date
2023-11-29
Business Address
ODASIA MALLORY M.S.
113 S. PERRY STREET 260
LAWRENCEVILLE, GA 30046
Phone number: 845-549-5055
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Mailing Address
ODASIA MALLORY M.S.
113 S PERRY ST STE 260
LAWRENCEVILLE, GA 30046-4811
Phone number: 845-549-5055
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