Individual
MALLORY BEARDSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
132 E GRAND RIVER AVE STE 205, BRIGHTON, MI 48116-1510
(989) 239-0870
Mailing address
701 MICHIGAN ST, PETOSKEY, MI 49770-2645
(989) 239-0870
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401018036
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6401018036
—
MI
Enumeration date
12/31/2018
Last updated
10/05/2023
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