Individual
MARY MALLAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW,LCSW, LCAC
Contact information
Practice address
1531 13TH ST STE G800, COLUMBUS, IN 47201-1315
(317) 220-1721
Mailing address
3925 S GARTHWAITE RD, GAS CITY, IN 46933-1155
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
87001609A
IN
1041C0700X
Clinical Social Worker
Primary
34007262A
IN
Other
Enumeration date
07/19/2019
Last updated
07/19/2019
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