Mallory R Wines, LPC

NPI #1154731354 in Lisbon, Ohio

Provider Information

NPI Number: 1154731354
Entity Type: Individual
Name: Mallory R Wines, LPC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Mental Health
Credential: LPC
Enumeration Date: Apr 28, 2014
Last Updated: Feb 24, 2017

Practice Location

Address: 7880 LINCOLE PL
City: Lisbon
State: Ohio
ZIP Code: 44432-8322
Phone: (330) 424-7221

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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