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General NPI Number Information
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NPI Number | 1154494417
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Entity Type | Individual
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Provider Name | RICHARD A. MALLARD M.S.
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Gender | Male
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2906 FRANCISCAN DR APT.1715
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City | ARLINGTON
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State | TX
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Zip | 76015-2575
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Country | US
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Telephone | 469-628-4368
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Fax | 817-784-1917
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Provider Business Mailing Address
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Address Line | PO BOX 152878
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City | ARLINGTON
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State | TX
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Zip | 76015-8878
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Country | US
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Telephone | 469-628-4368
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Fax | 817-784-1917
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 7407
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License Number State | TX
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