Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mallory Peterson

Individual provider Speech-Language Pathologist · NPI 1104519867

Mallory Peterson is a Speech-Language Pathologist in Titusville, Florida. Practices as a sole proprietor. Registered with an NPI since 2023.

In the registry since
2023

Practice location Address checks out

2625 Barna Ave Ste H
Titusville, FL 32780-3417
Phone: (321) 362-4099
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Speech-Language Pathologist (primary) Taxonomy 235Z00000X

Record details

NPI number1104519867
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMay 30, 2023
Last updated in NPPESMay 30, 2023
Certification dateMay 30, 2023
Mailing address1680 Rochelle Pkwy, Merritt Island, FL 32952-5650

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