Individual provider · Type 1 NPI

Travis Maurice Mallory

Mental Health Counselor · Lincoln, NE

NPI number 1720676083 Active

Practice location

2641 S 70th St Ste A
Lincoln, NE 68506-2912

Mailing address

5308 S 65th Street Cir
Lincoln, NE 68516-2382

Specialties and licenses

TaxonomyCodeLicense
Social Worker 104100000XCPSS-070 (NE)
Mental Health Counselor Primary 101YM0800XNone listed

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About NPI 1720676083

Travis Maurice Mallory's National Provider Identifier is 1720676083, issued on Jan 4, 2021. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Lincoln, NE. The record was last updated on Aug 2, 2021.