Individual
MS. MALLORY DAWN FOOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW, LMAC
Contact information
Practice address
5500 E KELLOGG DR, WICHITA, KS 67218-1607
(316) 685-2222
Mailing address
5500 E KELLOGG DR, WICHITA, KS 67218-1607
(316) 685-2222
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
094
KS
104100000X
Social Worker
Primary
10740
KS
Other
Enumeration date
06/05/2023
Last updated
06/05/2023
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