Mallory Sisson
Counselor, Mental Health in Dixon, IL. Individual provider (NPI-1).
NPI number1790455673
StatusActive
Last updated in NPPESSep 14, 2021
Details
- NPI
- 1790455673
- Entity type
- Individual (NPI-1)
- Name
- Mallory Sisson
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 14, 2021
- Certification date
- Sep 14, 2021
- Last updated
- Sep 14, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | – | Yes |
Practice location
325 Il Route 2Dixon, IL 61021-9118
Phone 815-284-6611
Mailing address
325 Il Route 2Dixon, IL 61021-9118
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