Provider Demographics
NPI:1114666484
Name:STEINER, MALLORY GRACE (AUD)
Entity Type:Individual
Prefix:DR
First Name:MALLORY
Middle Name:GRACE
Last Name:STEINER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 CENTRAL AVE UNIT 556
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33713-8991
Mailing Address - Country:US
Mailing Address - Phone:205-310-6515
Mailing Address - Fax:
Practice Address - Street 1:5881 RAND BLVD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34238-5115
Practice Address - Country:US
Practice Address - Phone:767-727-6341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-03
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2584231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist