Individual
KIRSTEN MALLORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
229 UPPER COVE RD, WOODBURY, GA 30293-3906
(808) 347-9115
Mailing address
229 UPPER COVE RD, WOODBURY, GA 30293-3906
(808) 347-9115
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP008337
GA
Other
Enumeration date
12/15/2013
Last updated
08/08/2022
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