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Individual

MADISON JEAN MALLOY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPCA

Contact information

Practice address
211 CLOVER LN STE J, LOUISVILLE, KY 40207-2754
(502) 771-1183
Mailing address
12945 W HIGHWAY 42, PROSPECT, KY 40059-9107

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
04/26/2023
Last updated
06/01/2025
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