Organization
AUDREY MALLOY SLP INC
Active
Other names
Sunshine Pediatric Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AUDREY MALLOY (PRESIDENT/SLP)
(318) 855-3150
Entity
Organization
Contact information
Practice address
1890 HUDSON CIR, SUITE 4, MONROE, LA 71201-3538
(318) 855-3150
Mailing address
1890 HUDSON CIR, SUITE 4, MONROE, LA 71201-3538
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Z12261
LA
235Z00000X
Speech-Language Pathologist
Primary
3812
LA
Other
Enumeration date
03/09/2011
Last updated
03/09/2011
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