Individual
HEATHER MALLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2915 W ESTRELLA ST APT 1, TAMPA, FL 33629-6051
(863) 944-3178
Mailing address
2915 W ESTRELLA ST APT 1, TAMPA, FL 33629-6051
(863) 944-3178
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
033592
NY
235Z00000X
Speech-Language Pathologist
SA16392
FL
Other
Enumeration date
08/31/2021
Last updated
12/12/2023
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