Individual
REGINA MALLORY MALLORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
142 STILLWATER LOOP, COLUMBUS, MT 59019-7326
(913) 558-7638
Mailing address
142 STILLWATER LOOP, COLUMBUS, MT 59019-7326
(913) 558-7638
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
989-LCSW
MT
Other
Enumeration date
06/14/2011
Last updated
06/14/2011
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