Individual
MALLORY KRKOSKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S
Contact information
Practice address
6437 RUCKER RD, SUITE D, INDIANAPOLIS, IN 46220-4885
(317) 405-9016
Mailing address
9959 BUTTONDOWN LN, ZIONSVILLE, IN 46077-8133
(925) 451-9578
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
46002979A
IN
Other
Enumeration date
07/20/2016
Last updated
01/03/2022
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