Individual
MALLORY MAHAFFEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LADC
Contact information
Practice address
13603 80TH CIR N, MAPLE GROVE, MN 55369-8961
(651) 379-1718
Mailing address
6880 LOST LAKE RD, EGG HARBOR, WI 54209-9229
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
303834
MN
Other
Enumeration date
01/27/2025
Last updated
01/27/2025
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