Mallory Colleen Bouque

NPI #1023861341 in Garfield Heights, Ohio

Provider Information

NPI Number: 1023861341
Entity Type: Individual
Name: Mallory Colleen Bouque
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Apr 8, 2024
Last Updated: Sep 3, 2024

Practice Location

Address: 13201 GRANGER RD
City: Garfield Heights
State: Ohio
ZIP Code: 44125-1978
Phone: (248) 464-3927

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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