Individual provider · Type 1 NPI
Mallory Mancuso
Student in an Organized Health Care Education/Training Program · Lafayette, LA
NPI number
1114491685
Active
Practice location
110 Lana Dr
Lafayette, LA 70503-4505
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program Primary | 390200000X | None listed |
Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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About NPI 1114491685
Mallory Mancuso's National Provider Identifier is 1114491685, issued on Jan 17, 2019. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Lafayette, LA. The record was last updated on Jan 17, 2019.