Individual
ELIZABETH PAYNE MALLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1711 PARRISH PLAZA DR, OWENSBORO, KY 42301-3482
(270) 691-0501
(270) 691-0510
Mailing address
1711 PARRISH PLAZA DR, OWENSBORO, KY 42301-3482
(270) 691-0501
(270) 691-0510
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3507
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100295000
—
KY
05
—
7100296110
—
KY
Enumeration date
06/02/2011
Last updated
09/27/2022
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