Individual
SUSAN R MALLORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
445 WINN WAY, DEKALB COMMUNITY SERVICE BOARD WINN WAY MHC, DECATUR, GA 30030
(404) 294-7700
Mailing address
2133 KODIAK DR NE, ATLANTA, GA 30345-4149
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
055425
GA
Other
Enumeration date
08/22/2006
Last updated
04/04/2014
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