Individual
MRS. MALLORY BOEHLER BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
719 ROSEDALE RD, WOODSTOCK, GA 30189-6106
(731) 439-0642
Mailing address
719 ROSEDALE RD, WOODSTOCK, GA 30189-6106
(731) 439-0642
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP009174
GA
Other
Enumeration date
08/18/2016
Last updated
08/18/2016
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