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Individual

MALLORY MARIE GONYER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.A., LPC, LBA, BCBA

Contact information

Practice address
28286 BOERNE STAGE RD. #3, BOERNE, TX 78006
(830) 816-5510
(855) 421-1717
Mailing address
28286 BOERNE STAGE RD. #3, BOERNE, TX 78006
(830) 816-5510
(855) 421-1717

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
71038
TX
101YP2500X
Professional Counselor
71038
TX
103K00000X
Behavior Analyst
Primary
1-15-18128
TX
103K00000X
Behavior Analyst
1-15-18128

Other

Enumeration date
11/07/2014
Last updated
10/18/2023
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