Individual
MR. MICHAEL DAVID MALLOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
7101 EXECUTIVE CENTER DR BLDG 5, SUITE 290, BRENTWOOD, TN 37027-5236
(615) 376-6411
Mailing address
PO BOX 3574, BRENTWOOD, TN 37024-3574
(615) 376-6411
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LSW 3136
TN
Other
Enumeration date
01/30/2007
Last updated
07/08/2007
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