Individual
DANIELLE LEE MALLORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN FNP-BC
Contact information
Practice address
620 NORWICH NEW LONDON TPKE, UNCASVILLE, CT 06382-2121
(860) 892-8012
Mailing address
141 WAY RD, SALEM, CT 06420-3716
(860) 949-4182
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
8280
CT
Other
Enumeration date
07/03/2019
Last updated
09/08/2021
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