Individual
MRS. KATHRYN CHATTERTON MALLORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPS
Contact information
Practice address
318 SLATER ST, FAIRBANKS, AK 99701-2923
(907) 457-1101
(907) 457-1121
Mailing address
318 SLATER ST, FAIRBANKS, AK 99701-2923
(907) 457-1101
(907) 457-1121
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
135481
AK
101YM0800X
Mental Health Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1596091
—
AK
Enumeration date
06/05/2018
Last updated
03/28/2019
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