Individual
JOHN F MALLERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LISW
Contact information
Practice address
4075 OLD WESTERN ROW RD, MASON, OH 45040-3104
(513) 536-4673
(513) 536-0609
Mailing address
4075 OLD WESTERN ROW RD, MASON, OH 45040-3104
(513) 536-4673
(513) 536-0609
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
1440065
OH
1041C0700X
Clinical Social Worker
Primary
34004747A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000354542
BLUE SHIELD
IN
Enumeration date
01/18/2007
Last updated
03/05/2015
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