Ivy J Mallisham is a Clinical in Columbus, Georgia. Ivy J Mallisham practices all healthcare services and medical treatments related to Clinical. The NPI Number for Ivy J Mallisham is 1689653743. The last update date is 2007-07-09.
Ivy J Mallisham's current location address is 5041 Warm Springs Rd, Columbus, Georgia. You can contact this provider via phone number 7065699199 and fax number 7065698990. The mailing address for Ivy J Mallisham is 5041 Warm Springs Rd, Columbus, Georgia. To know further, please read the information below!
Provider Profile Detail
Provider Name | Ivy J Mallisham |
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Address | 5041 Warm Springs Rd, Columbus, Georgia |
Phone Number | 7065699199 |
Fax Number | 7065698990 |
Sole Proprietor | Y |
Credentials | PSY.D. |
NPI Number Detail
NPI Number | 1689653743 |
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Provider Enumeration Date | 2006-01-16 |
Last Updated Date | 2007-07-09 |
Provider Mailing Address Detail
Address | 5041 Warm Springs Rd |
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City | Columbus |
State | Georgia (GA) |
Post Code | 319096938 |
Phone Number | 7065699199 |
Fax Number | 7065698990 |
Provider's Primary Taxonomy Detail
Speciality | Clinical |
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Taxonomy | 103Tc0700X |
Licence No | PSY001132 |
Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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What is the unique identifier code issued to Ivy J Mallisham by the Centers for Medicare & Medicaid Services?
The Ivy J Mallisham has been assigned the NPI (National Provider Identifier) 1689653743. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Ivy J Mallisham's physical address?
The Ivy J Mallisham is physically located at 5041 Warm Springs Rd, in the city of Columbus, GA, with the postal code 319096938.
What is Ivy J Mallisham's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Ivy J Mallisham is Clinical, and the taxonomy classification code that categorizes this area of expertise is 103Tc0700X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1689653743 to Ivy J Mallisham?
The Centers for Medicare & Medicaid Services originally issued the 1689653743 to Ivy J Mallisham on 2006-01-16.
When was the information pertaining to Ivy J Mallisham most recently updated or revised?
The details related to Ivy J Mallisham, including its address, specialty, and other relevant information, were last updated or revised on 2007-07-09.
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