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1659932069
MALLORY LEATHERMAN 062519
FORT WAYNE, IN
NPI
1659932069
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2019-06-26
Last Update Date
2019-06-26
Business Address
MALLORY LEATHERMAN 062519
3900 HURSH RD
FORT WAYNE, IN 46845-9677
Phone number: 260-637-3608
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Mailing Address
MALLORY LEATHERMAN 062519
8515 BLUFFTON RD
FORT WAYNE, IN 46809-3022
Phone number:
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