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Individual

DR. DONNA MARIE MALLORY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AU.D.

Contact information

Practice address
2002 ORANGE RD, SUITE 105, CULPEPER, VA 22701-4170
(540) 829-9005
(540) 829-9056
Mailing address
2002 ORANGE RD, SUITE 105, CULPEPER, VA 22701-4170

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
2201000649
VA
231HA2500X
Assistive Technology Supplier Audiologist
2101001248
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010332371
VA
Enumeration date
10/28/2005
Last updated
07/13/2015
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