| 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 |