Individual
WILLIAM PAUL MALLOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
925 STATE HWY VV, KENNETT, MO 36857
(573) 359-2600
Mailing address
581 HWY J NORTH, HAYTI, MO 63851-0441
(573) 359-2600
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
11/14/2017
Last updated
11/14/2017
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