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Individual

MALLERY LYNN VANNOY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1611 PEACH ST, ERIE, PA 16501-2109
(800) 805-6989
Mailing address
1926 AVON DR, ERIE, PA 16509-3428
(814) 462-8479

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
NA

Other

Enumeration date
07/15/2021
Last updated
07/15/2021
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