Individual
JENNIFER MALLORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
STNA
Contact information
Practice address
2215 E 81ST ST, CLEVELAND, OH 44103-5003
(216) 609-8394
Mailing address
2215 E 81ST ST, CLEVELAND, OH 44103-5003
(216) 609-8394
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
193400000X
OH
Other
Enumeration date
07/30/2014
Last updated
07/30/2014
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