Mallory Wilson
Counselor, Addiction (Substance Use Disorder) in Cleveland, OH. Individual provider (NPI-1).
NPI number1982308599
StatusActive
Last updated in NPPESMar 28, 2023
Details
- NPI
- 1982308599
- Entity type
- Individual (NPI-1)
- Name
- Mallory Wilson
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 28, 2023
- Certification date
- Mar 28, 2023
- Last updated
- Mar 28, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | – | – | Yes |
Practice location
4401 W 150th StCleveland, OH 44135-1311
Phone 440-840-2252
Mailing address
516 Beachcliff Row DrRocky River, OH 44116-1800
Phone 440-840-2252
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