Individual
LAURA W MALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1030 FAYETTEVILLE RD SE, ATLANTA, GA 30316-2921
(404) 486-9034
Mailing address
310 OXFORD HALL DR, ALPHARETTA, GA 30005-4390
(678) 393-8849
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/10/2020
Last updated
07/10/2020
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