| NPI | 1306227426 |
|---|---|
| Former Name | STEPHANIE AMBER MALLERY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: OH 35.133723) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35133723) |
| 208D00000X General Practice (Licence: OH 35.133723) | |
| 207P00000X Emergency Medicine (Licence: MI 4301107856) | |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2025-09-08 |