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General NPI Number Information
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NPI Number | 1336442839
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Entity Type | Individual
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Provider Name | MALLORY F. FIERY MA
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Gender | Female
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Dates
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Enumeration Date | 12/06/2010
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Last Update Date | 09/28/2014
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Provider Practice Location Address
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Address Line | 518 S ASPEN ST
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City | LINCOLNTON
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State | NC
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Zip | 28092-2735
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Country | US
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Telephone | 704-530-0850
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Fax |
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Provider Business Mailing Address
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Address Line | 518 S ASPEN ST
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City | LINCOLNTON
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State | NC
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Zip | 28092-2735
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Country | US
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Telephone | 704-530-0850
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Fax |
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 4642
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License Number State | NC
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