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General NPI Number Information
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NPI Number | 1265240543
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Entity Type | Organization
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Legal Business Name | MALLORY PSYCHOLOGICAL AND CONSULTING SERVICES, LLC
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Dates
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Enumeration Date | 12/19/2024
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Last Update Date | 12/19/2024
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Provider Practice Location Address
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Address Line | 40 BURTON HILLS BLVD STE 200
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City | NASHVILLE
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State | TN
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Zip | 37215-5902
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Country | US
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Telephone | 615-412-8909
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Fax |
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Provider Business Mailing Address
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Address Line | 11205 LEBANON RD PMB 1008
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City | MT. JULIET
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State | TN
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Zip | 37122-5545
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Country | US
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Telephone | 615-412-8909
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Fax | 615-358-9186
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Authorized Official
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Title or Position | LICENSED PSYCHOLOGIST, OWNER
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Name | YVETTE MALLORY
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Credential | PSYD
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Telephone | 615-412-8909
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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