Individual
AMANDA LEEANN MALLORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
909 ALAMEDA ST, NORMAN, OK 73071-5229
(405) 573-3921
(405) 573-8245
Mailing address
205 GREAT OAKS DR., NORMAN, OK 73071-4325
(405) 808-5163
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5133-P
OK
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
02/07/2013
Last updated
03/17/2018
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