Individual
DR. MALLORIE GAYLE CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1670 CLAIRMONT RD, DECATUR, GA 30033-4004
(404) 321-6111
Mailing address
1508 SUGARPLUM PL SW, CONYERS, GA 30094-6844
(251) 366-2345
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
2175
AL
Other
Enumeration date
09/28/2020
Last updated
09/28/2020
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