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1477845147
MALLORY BARBARA HERRIN
APPLETON, WI
NPI
1477845147
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI 16148-130)
Enumeration Date
2011-05-12
Last Update Date
2011-05-12
Business Address
-- MALLORY BARBARA HERRIN SAC-IT
820 W. COLLEGE AVE
APPLETON, WI 54914
Phone number: 920-730-1323
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Mailing Address
-- MALLORY BARBARA HERRIN SAC-IT
820 W COLLEGE AVE
APPLETON, WI 54914-5286
Phone number: 920-730-1323
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