Individual
MALLORY ELIZABETH SMITHART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1247 RUCKER BLVD STE 3, ENTERPRISE, AL 36330-3630
(334) 347-5003
Mailing address
13825 US HIGHWAY 29, ANDALUSIA, AL 36420-7233
(334) 892-4311
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
AL
Other
Enumeration date
10/13/2020
Last updated
10/13/2020
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