Individual
MALLORY MICHAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
975 KIRMAN AVE, CH124, RENO, NV 89502
(775) 419-4899
Mailing address
740 LONG VALLEY RD, GARDNERVILLE, NV 89460-8138
(775) 741-0359
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
10086-C
NV
Other
Enumeration date
06/27/2022
Last updated
06/27/2022
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