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Individual

MALLORY DELAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3928 S NOVA RD, PORT ORANGE, FL 32127-4911
(386) 822-9941
Mailing address
1630 N PAGE DR, DELTONA, FL 32725-6020
(352) 457-8046

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
01/10/2023
Last updated
01/10/2023
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