Individual
MALLORY LYNNE MIZVITOWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
2002 SPROUL RD FL 3, BROOMALL, PA 19008-3510
(610) 626-8085
Mailing address
207 W DUPONT ST, RIDLEY PARK, PA 19078-3207
(215) 605-9015
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
SP028758
PA
Other
Enumeration date
02/29/2024
Last updated
02/29/2024
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