| NPI | 1396303418 |
|---|---|
| Former Name | MALLORY WAGNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 170300000X Genetic Counselor, MS (Licence: MI 7201000049) |
| Additional Taxonomies | 170300000X Genetic Counselor, MS |
| Enumeration Date | 2019-06-04 |
| Last Update Date | 2025-11-24 |