| NPI | 1225526387 |
|---|---|
| Former Name | MALLORY REYNOLDS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CO 0003151) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NY 025731-1) |
| Enumeration Date | 2018-04-24 |
| Last Update Date | 2018-04-24 |