Most Relevant Information
Provider Data
| NPI Number: | 1003273871 |
| Provider Name: | MALLORY ROSE LUTES |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/25/2016 |
| Last Updated: | 01/25/2016 |
Provider Practice Location
1100 WALNUT ST
OWENSBORO
KY
423012956
Practice Location Phone/Fax
| Phone: | 2706896681 |
| Fax: |
Provider Mailing Location
1100 WALNUT ST
OWENSBORO
KY
423012956
Provider Mailing Phone/Fax
| Phone: | 2706896681 |
| Fax: |