Individual
COLLEEN MALLORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3418 TOWN AND COUNTRY DR, SAN ANGELO, TX 76903
(325) 653-4673
Mailing address
705 W 15TH ST, SAN ANGELO, TX 76903
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
89218
TX
Other
Enumeration date
07/25/2022
Last updated
07/25/2022
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