Individual
MALLORY J EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3312 ASHBY RD, SAINT ANN, MO 63074-3529
(314) 493-6200
Mailing address
12110 CLAYTON RD, SAINT LOUIS, MO 63131-2516
(314) 989-8100
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2020018835
MO
Other
Enumeration date
09/14/2020
Last updated
09/14/2020
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