Individual
EBONY MALLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2801 BUFORD HWY NE STE 501, BROOKHAVEN, GA 30329-2137
(404) 491-0377
Mailing address
2609 WATERDALE RD SW, ATLANTA, GA 30331-8125
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC006830
GA
Other
Enumeration date
05/18/2012
Last updated
03/11/2025
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