Individual
JUSTICE MALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15 FERNDALE DR, SMYRNA, DE 19977-4532
(302) 740-4375
Mailing address
15 FERNDALE DR, SMYRNA, DE 19977-4532
(302) 740-4375
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
L1-0053610
DE
Other
Enumeration date
02/14/2024
Last updated
02/14/2024
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