Individual
MALLORY J WILKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS,CCC-SLP
Contact information
Practice address
401 E BOGARD RD, WASILLA, AK 99654-7108
(907) 357-2578
(907) 357-2529
Mailing address
401 E BOGARD RD, WASILLA, AK 99654-7108
(907) 357-2578
(907) 357-2578
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
124014
AK
Other
Enumeration date
05/06/2019
Last updated
05/06/2019
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