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General NPI Number Information
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NPI Number | 1093505265
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Entity Type | Organization
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Legal Business Name | MALLORY CRAIG PSYCHOTHERAPY LLC
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Dates
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Enumeration Date | 05/09/2025
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 122 BERRY AVE
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City | MORRISVILLE
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State | VT
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Zip | 05661-9172
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Country | US
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Telephone | 802-752-8666
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Fax |
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Provider Business Mailing Address
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Address Line | 122 BERRY AVE
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City | MORRISVILLE
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State | VT
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Zip | 05661-9172
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Country | US
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Telephone | 802-752-8666
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. MALLORY CRAIG
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Credential | MA
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Telephone | 802-752-8666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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