Individual
MALLORY BRANDENBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
363 W LINCOLN TRAIL BLVD, RADCLIFF, KY 40160-3302
(270) 351-1133
Mailing address
363 W LINCOLN TRAIL BLVD, RADCLIFF, KY 40160-3302
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
247643
KY
Other
Enumeration date
04/16/2019
Last updated
04/16/2019
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