Individual
MRS. HALEY MAE ASHTON MALLOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
52 PERRY ST, NEWNAN, GA 30263-1974
(678) 854-2100
Mailing address
52 PERRY ST, NEWNAN, GA 30263-1974
(678) 854-2100
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/02/2021
Last updated
03/02/2021
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