Individual
MALLORY LEIBLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
206 HOSPITAL LN, PERRYVILLE, MO 63775-1448
(573) 768-3216
Mailing address
165 WOODHAVEN, PERRYVILLE, MO 63775-6292
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2023020711
MO
Other
Enumeration date
10/05/2023
Last updated
10/05/2023
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