Individual
JENNIFER ALICE MALLORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDCA
Contact information
Practice address
5108 SANDY LN, FAIRFIELD, OH 45014
(513) 834-7063
(513) 816-7789
Mailing address
446 MORGAN ST, CINCINNATI, OH 45206-2348
(513) 834-7063
(513) 873-1567
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CDCA.165090
OH
Other
Enumeration date
12/11/2017
Last updated
07/09/2018
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