Individual
MALLORY TQ GRIFFIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
2117 METRO CIR SW # A, HUNTSVILLE, AL 35801-5343
(256) 701-3134
Mailing address
100 SPENRYN DR, MADISON, AL 35758-1890
(256) 772-4400
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
17-31784
AL
Other
Enumeration date
06/12/2019
Last updated
09/11/2024
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