Individual provider · Type 1 NPI

Ivory G. Mallory

Addiction (Substance Use Disorder) Counselor · San Antonio, TX

NPI number 1316553191 Active

Practice location

6800 Park Ten Blvd Ste 200S
San Antonio, TX 78213-4293

Call (210) 261-1000 Map

Fax (210) 261-1821

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X15154 (TX)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1316553191

Ivory G. Mallory's National Provider Identifier is 1316553191, issued on Sep 17, 2020. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in San Antonio, TX. The record was last updated on Sep 17, 2020.