Individual
MALLORY NICHOLE HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
21000 E 12 MILE RD STE 111, SAINT CLAIR SHORES, MI 48081-1156
(586) 779-7610
Mailing address
5428 BURTON RD, MUSSEY, MI 48014-1111
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
1601001020
MI
Other
Enumeration date
05/21/2021
Last updated
07/15/2022
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