| Doctor Name: | MRS. VICTORIA MALLOY |
| NPI Number: | 1205094554 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCPC |
| License Number: | 180-006914 |
| Business Practice Address: | 183 E Bethel Dr Bourbonnais, IL - 609141456 |
| Business Phone Number: | 8159391900 |
| Business Fax Number: | 8159391902 |
| Mailing Address: | 183 E Bethel Dr, BOURBONNAIS |
| State: | IL |
| Postal Code: | 609141456 |
| Phone Number: | 8159391900 |
| Fax Number: | 8159391902 |
| NPI Enumeration Date: | 05/22/2008 |
| NPI Last Update Date: | 08/24/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 180-006914 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |