Individual
AIDIAH SARAN MALLORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5043 FRANKFORD AVE, PHILADELPHIA, PA 19124-2644
(267) 324-9052
Mailing address
1231 KENWYN ST, PHILADELPHIA, PA 19124-2517
(267) 324-9052
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/10/2025
Last updated
11/10/2025
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