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General NPI Number Information
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NPI Number | 1427629468
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Entity Type | Individual
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Provider Name | MALLORY LOYD BCBA
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Gender | Female
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Dates
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Enumeration Date | 07/09/2021
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 701 SW F AVE
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City | LAWTON
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State | OK
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Zip | 73501-4542
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Country | US
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Telephone | 580-699-2700
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Fax |
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Provider Business Mailing Address
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Address Line | 701 SW F AVE
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City | LAWTON
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State | OK
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Zip | 73501-4542
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Country | US
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Telephone | 580-699-2700
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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 | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | 0-23-14494
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License Number State |
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-21-173969
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-25-79844
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License Number State | OK
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