Individual
MALLORY RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4475 GREENACRE DR, OWENSBORO, KY 42303-1835
(270) 315-4178
Mailing address
4475 GREENACRE DR, OWENSBORO, KY 42303-1835
(270) 315-4178
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
242069
KY
235Z00000X
Speech-Language Pathologist
SA16381
FL
Other
Enumeration date
10/26/2018
Last updated
10/26/2018
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