Individual
MALLORY KIERNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APSW
Contact information
Practice address
778 LOIS DR, SUN PRAIRIE, WI 53590-1100
(608) 755-5260
(608) 755-5267
Mailing address
17 S RIVER ST STE 254, JANESVILLE, WI 53548-3863
(608) 755-5260
(608) 755-5267
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
130860
WI
Other
Enumeration date
11/20/2017
Last updated
11/20/2017
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