Individual
DR. MALLORY GARZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
302 WYNNWOOD AVE, RUSTON, LA 71270-2653
(620) 231-9873
Mailing address
302 WYNNWOOD AVE, RUSTON, LA 71270-2653
(318) 729-8090
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
03223
KS
103TC1900X
Counseling Psychologist
Primary
1763
LA
103TC1900X
Counseling Psychologist
PSB94025204
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3088670
—
LA
Enumeration date
11/18/2019
Last updated
06/25/2026
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