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Individual

MALLORY RENAE BERRY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3400 N WOODS LN, ROGERS, AR 72756-6712
(479) 636-3190
Mailing address
3400 N WOODS LN, ROGERS, AR 72756-6712
(479) 636-3190

Taxonomy

Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
DDS#609
AR

Other

Enumeration date
11/05/2012
Last updated
11/05/2012
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