Individual
MRS. LAURIE MALLIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED.S.
Contact information
Practice address
5417 NW 108TH WAY, CORAL SPRINGS, FL 33076-2744
(954) 873-7624
Mailing address
5417 NW 108TH WAY, CORAL SPRINGS, FL 33076-2744
(954) 873-7624
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
SS1015
FL
Other
Enumeration date
09/27/2018
Last updated
09/27/2018
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