Provider Demographics
NPI:1336198977
Name:MALLCOTT, PAULINE ELIZABETH (MA, CCC-A)
Entity Type:Individual
Prefix:MRS
First Name:PAULINE
Middle Name:ELIZABETH
Last Name:MALLCOTT
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:925 N POINT PKWY
Mailing Address - Street 2:SUITE 130
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-5210
Mailing Address - Country:US
Mailing Address - Phone:770-740-1860
Mailing Address - Fax:678-261-1713
Practice Address - Street 1:2365 OLD MILTON PKWY
Practice Address - Street 2:SUITE 300
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-2140
Practice Address - Country:US
Practice Address - Phone:770-740-1860
Practice Address - Fax:770-753-0021
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GAAUD003614231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist