Individual
MALLORY NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SSP
Contact information
Practice address
1514 US ROUTE 34, BIGGSVILLE, IL 61418-5012
(309) 627-2371
Mailing address
1514 US ROUTE 34, BIGGSVILLE, IL 61418-5012
(309) 627-2371
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
IL
Other
Enumeration date
08/19/2021
Last updated
08/19/2021
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