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1639540420
STACY S MALLARE
COLUMBIA, MD
NPI
1639540420
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: MD R186082)
Enumeration Date
2015-10-19
Last Update Date
2015-10-19
Business Address
-- STACY S MALLARE
10954 HILLTOP LN
COLUMBIA, MD 21044-3780
Phone number: 410-718-3213
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Mailing Address
-- STACY S MALLARE
10954 HILLTOP LN
COLUMBIA, MD 21044-3780
Phone number: 410-718-3213
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