Individual
MALLORY ANN LEATHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. SLP
Contact information
Practice address
2104 E MALLORY ST, MESA, AZ 85213-1447
(480) 748-0948
Mailing address
2104 E MALLORY ST, MESA, AZ 85213-1447
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
TSLP7812
AZ
Other
Enumeration date
08/02/2012
Last updated
08/02/2012
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