Individual
MALLORY SIMS TYRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
3120 N OAK STREET EXT STE B, VALDOSTA, GA 31602-5910
(229) 671-6170
Mailing address
3120 N OAK STREET EXT STE B, VALDOSTA, GA 31602-5910
(229) 671-6170
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFT001575
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MFT001575
LICENSED MARRIAGE AND FAMILY THERAPIST
GA
Enumeration date
12/18/2017
Last updated
03/09/2026
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