| NPI | 1871602664 |
|---|---|
| Former Name | CONNIE F MALLO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: CO 81170) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2016-05-26 |