Individual
MALLORY DICKARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
207 W JACKSON ST, SUITE 2, RIDGELAND, MS 39157-2355
(601) 362-0859
Mailing address
415 LINCOLN AVE, GREENWOOD, MS 38930-2319
(662) 299-0049
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S3872
MS
Other
Enumeration date
07/09/2014
Last updated
07/09/2014
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