Individual
NATHANIEL MALLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4601 MARKET ST, PHILADELPHIA, PA 19139-4636
(215) 220-2127
Mailing address
4601 MARKET ST, PHILADELPHIA, PA 19139-4636
(215) 220-2127
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW142961
PA
Other
Enumeration date
08/21/2025
Last updated
08/21/2025
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