Individual
MALLORY MAHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
606 E SPRING ST, COOKEVILLE, TN 38501-5066
(931) 303-0665
Mailing address
606 E SPRING ST, COOKEVILLE, TN 38501-5066
(931) 303-0665
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YS0200X
School Counselor
000609761
TN
Other
Enumeration date
07/25/2019
Last updated
07/25/2019
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