Individual
MRS. CONNIE MALLORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
5936 MERCEDES AVE, DALLAS, TX 75206-5910
(214) 288-6854
Mailing address
5936 MERCEDES AVE, DALLAS, TX 75206-5910
(214) 288-6854
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
59983
TX
101YP2500X
Professional Counselor
59983
—
Other
Enumeration date
04/30/2022
Last updated
04/30/2022
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