Individual
HEATHER MARIE MALLOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDCA
Contact information
Practice address
2611 WAYNE AVE, DAYTON, OH 45420-1833
(937) 256-7801
Mailing address
4526 HANNAFORD ST, DAYTON, OH 45439-2718
(937) 681-6834
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
178987
OH
Other
Enumeration date
07/06/2022
Last updated
07/06/2022
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