Individual
MALLORY S PARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
848 HIRAM ACWORTH HWY BLDG 100, HIRAM, GA 30141-2286
(678) 818-5877
Mailing address
235 SUSIE CREEK LN, VILLA RICA, GA 30180-5214
(770) 365-1419
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
APC007183
GA
Other
Enumeration date
12/28/2020
Last updated
12/28/2020
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