NPI 1003410408
Tisha Dawn Mallow
Practice location
- Address
- 8 N Spring St, Buckhannon, WV 26201-2720
- Phone
- (304) 472-0395
- Fax
- (304) 471-2488
- Mailing address
- 101 Caboose Drive, Harman, WV 26270
Registered specialties (2)
Homemaker
Primary
Personal Care Attendant
Registry record
- NPI
- 1003410408
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 25 Nov 2020
- Record last updated
- 2 Oct 2023
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.