Provider Demographics
NPI:1952950990
Name:SCOFIELD, MALLORY (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MALLORY
Middle Name:
Last Name:SCOFIELD
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ALBERTVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35950-1625
Mailing Address - Country:US
Mailing Address - Phone:256-849-0444
Mailing Address - Fax:256-849-0445
Practice Address - Street 1:125 W MAIN ST
Practice Address - Street 2:
Practice Address - City:ALBERTVILLE
Practice Address - State:AL
Practice Address - Zip Code:35950-1625
Practice Address - Country:US
Practice Address - Phone:256-849-0444
Practice Address - Fax:256-849-0445
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-11
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty