Individual
LOREN E MALLORY
Active
Individual
LOREN E MALLORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, ABPP
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
978
OR
103TC0700X
Clinical Psychologist
0978
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
042544
—
OR
01
—
117227
MHN HMC
—
Enumeration date
01/08/2007
Last updated
04/09/2018
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