Autum Marie Mallick

NPI #1578108627 in Holt, Florida

Provider Information

NPI Number: 1578108627
Entity Type: Individual
Name: Autum Marie Mallick
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Technician - Attendant Care Provider
Enumeration Date: Nov 13, 2019
Last Updated: Nov 14, 2019

Practice Location

Address: 7165 TEE DON CT
City: Holt
State: Florida
ZIP Code: 32564-8925
Phone: (850) 313-9846

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chore Provider	372500000X
Technician - Attendant Care Provider — Attendant Care Provider	3747A0650X	Primary

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