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Individual
MALLORY GRACIA-ROSE THOMSEN
Active
Individual
MALLORY GRACIA-ROSE THOMSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LMSW, MSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
095648
NY
1041C0700X
Clinical Social Worker
6801117659
MI
Other
Enumeration date
01/22/2020
Last updated
05/28/2024
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