Most Relevant Information
Provider Data
| NPI Number: | 1003179516 |
| Provider Name: | MALLORIE MICHELLE MONK |
| Entity Type: | Individual |
| Taxonomy Code: | 251S00000X |
| Specialty: | Community/Behavioral Health |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/19/2012 |
| Last Updated: | 06/19/2012 |
Provider Practice Location
4904 CANADIAN DR
LAS VEGAS
NV
891302218
Practice Location Phone/Fax
| Phone: | 7025269908 |
| Fax: |
Provider Mailing Location
4904 CANADIAN DR
LAS VEGAS
NV
891302218
Provider Mailing Phone/Fax
| Phone: | 7025269908 |
| Fax: |