Individual
MALLORY WINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CF, SLP
Contact information
Practice address
824 N TYLER ST, LITTLE ROCK, AR 72205-3535
(501) 664-2961
Mailing address
13819 IRONTON CUT OFF RD, LITTLE ROCK, AR 72206-5279
(501) 765-2881
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
202687
AR
Other
Enumeration date
06/05/2024
Last updated
06/05/2024
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