Individual
MALLORY WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13155 SW 134TH ST, MIAMI, FL 33186-4486
(786) 306-2453
Mailing address
10132 SW 77TH CT, MIAMI, FL 33156-2657
(305) 877-3247
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
SI3854
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SPEECH
—
FL
Enumeration date
01/25/2019
Last updated
01/25/2019
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