Individual
STEPHANIE ANGELA MALLOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
110 CHURCH ST, PHILADELPHIA, PA 19106-2201
(267) 807-0550
Mailing address
2831 S ALDER ST, PHILADELPHIA, PA 19148-4910
(215) 983-9199
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/25/2024
Last updated
11/25/2024
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