Provider Demographics
NPI:1235979329
Name:ARIZA, MALLORY ANNE (RCSWI)
Entity type:Individual
Prefix:MRS
First Name:MALLORY
Middle Name:ANNE
Last Name:ARIZA
Suffix:
Gender:F
Credentials:RCSWI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 CENTRE POINTE BLVD APT 122
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4878
Mailing Address - Country:US
Mailing Address - Phone:850-603-3667
Mailing Address - Fax:
Practice Address - Street 1:1363 E LAFAYETTE ST APT 122
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-4799
Practice Address - Country:US
Practice Address - Phone:850-926-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical