Individual
AUDREY MALLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
301 PALMETTO PARK BLVD, LEXINGTON, SC 29072-7872
(803) 359-3545
Mailing address
3207 LAKEWOOD AVE, COLUMBIA, SC 29201-1433
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/30/2016
Last updated
06/30/2016
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