Individual
JENNIFER MALLORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1115 HARBER ROAD, GROVE, OK 74344
(918) 786-4434
(918) 786-4435
Mailing address
1115 HARBER ROAD, GROVE, OK 74344
(918) 786-4434
(918) 786-4435
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
10/29/2007
Last updated
09/12/2014
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