Provider Demographics
NPI:1841539400
Name:MARGARET MALLORY, PH.D. & ASSOCIATES, LLC
Entity type:Organization
Organization Name:MARGARET MALLORY, PH.D. & ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:L
Authorized Official - Last Name:MALLORY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:240-602-1107
Mailing Address - Street 1:4712 MORNING GLORY TRL
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-4246
Mailing Address - Country:US
Mailing Address - Phone:240-602-1107
Mailing Address - Fax:240-266-2583
Practice Address - Street 1:4405 E WEST HWY
Practice Address - Street 2:SUITE 512
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-4522
Practice Address - Country:US
Practice Address - Phone:301-656-2487
Practice Address - Fax:240-266-2583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-01
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04522103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty