Herndon, Mallory Kathleen
Herndon, Mallory Kathleen is an sole proprietor health care provider with primary practice located at 458 Barcelona Rd , Palm Bay FL 32909. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as her primary health care specialty. Herndon, Mallory Kathleen can be contacted via phone (321) 795-2670.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Behavior Technician | 106S00000X |
Profile Details
| NPI number | 1306348859 |
|---|---|
| LBN Legal business name | Herndon, Mallory Kathleen |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 1st, 2018 |
| Last updated | Mar 1st, 2018 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306348859 | NPPES |
| Florida | MEDICAID | 106S00000X |
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