Individual
MALORY DIANE KOLP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
515 OAK ST STE E, CONWAY, AR 72032-4464
(501) 697-8053
(501) 232-4130
Mailing address
1156 MEADOWS DR, BENTON, AR 72019-8789
(501) 802-4317
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
11919-M
AR
Other
Enumeration date
10/28/2022
Last updated
10/28/2022
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