Individual
MALLORY LYNN SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
8745 PALM BREEZE RD APT 1520, JACKSONVILLE, FL 32256-3765
(205) 615-7650
Mailing address
8745 PALM BREEZE RD APT 1520, JACKSONVILLE, FL 32256-3765
(205) 615-7650
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6228G
AL
Other
Enumeration date
05/26/2023
Last updated
05/26/2023
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