Odasia Mallory, M.S

NPI 1205078086 · on the registry since 2009 · sole proprietor

Practice

Address: 113 S. Perry Street
260
Lawrenceville, GA 30046
Phone: (845) 549-5055
Organisation at this address: Hc Roots Llc
Da Big Jus Wayyy
The Mind Spa Llc
Specme Eyewear Llc
Uneke Wellness Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 15

Registry record

Primary taxonomy: 235Z00000X
235Z00000X
Licence states on file: GA
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2023-11-29

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia