NPI | 1972018182 |
---|---|
Other Name | JENNY ALICE MALLORY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.165090) |
Enumeration Date | 2017-12-11 |
Last Update Date | 2018-07-09 |