Provider Demographics
NPI:1396625554
Name:MALLOY, LEAH
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:MALLOY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:HUTCHINSON
Other - Last Name:MALLOY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:104 RED FOX LN
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-1529
Mailing Address - Country:US
Mailing Address - Phone:214-336-7527
Mailing Address - Fax:
Practice Address - Street 1:104 RED FOX LN
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-1529
Practice Address - Country:US
Practice Address - Phone:214-336-7527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-06
Last Update Date:2025-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99780101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor