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Individual
PENNY O'MALLOY
Active
Individual
PENNY O'MALLOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CDCA.166712
OH
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.170486
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0314559
—
OH
Enumeration date
07/09/2018
Last updated
04/21/2023
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