Individual
WILLIAM FRANCIS MALLORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
HIGHWAY 75/77, WINNEBAGO IHS HOSPITAL, WINNEBAGO, NE 68071-0767
(402) 878-2231
(402) 878-2535
Mailing address
601 W 17TH ST, SOUTH SIOUX CITY, NE 68776-2119
(402) 878-2231
(402) 878-2535
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
100
NE
Other
Enumeration date
05/03/2011
Last updated
05/03/2011
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