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1316553191
IVORY G MALLORY
SAN ANTONIO, TX
NPI
1316553191
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: TX 15154)
Enumeration Date
2020-09-17
Last Update Date
2020-09-17
Business Address
IVORY G MALLORY
6800 PARK TEN BLVD STE 200S
SAN ANTONIO, TX 78213-4293
Phone number: 210-261-1000
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Mailing Address
IVORY G MALLORY
6800 PARK TEN BLVD STE 200S
SAN ANTONIO, TX 78213-4293
Phone number: 210-261-1000
Copy
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