| Doctor Name: | MALLORY SCHWARTZ |
| NPI Number: | 1063867224 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A., L.L.P.C. |
| License Number: | 6401014584 |
| Business Practice Address: | 30800 Telegraph Rd Ste. 1775 Bingham Farms, MI - 480254542 |
| Business Phone Number: | 2486290709 |
| Business Fax Number: | |
| Mailing Address: | 14290 Borgman St, OAK PARK |
| State: | MI |
| Postal Code: | 482376901 |
| Phone Number: | 2484212898 |
| Fax Number: | |
| NPI Enumeration Date: | 04/25/2016 |
| NPI Last Update Date: | 04/25/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 6401014584 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |