MALLORY MIRACLE

CRESTWOOD, KY
NPI1538507413
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy235Z00000X Speech-Language Pathologist,
(Licence: KY  12-043)
Enumeration Date2013-06-12
Last Update Date2013-06-12
Business Address
-- MALLORY MIRACLE
6317 HIGHWAY 329
CRESTWOOD, KY 40014-9040
Phone number: 502-384-0910
Mailing Address
-- MALLORY MIRACLE
4529 BILES CT
LOUISVILLE, KY 40241-3703
Phone number: 816-830-3840
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