Individual
KATRINA MALLORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3700 W KILGORE AVE, MUNCIE, IN 47304-4810
(765) 289-5437
Mailing address
3700 W KILGORE AVE, MUNCIE, IN 47304-4810
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
—
—
Other
Enumeration date
10/03/2013
Last updated
08/07/2019
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