Individual
MR. MALVIN DOUGLAS MUNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
220 GALA CIR, DAYTONA BEACH, FL 32124-2012
(386) 576-6332
Mailing address
220 GALA CIR, DAYTONA BEACH, FL 32124-2012
(386) 576-6332
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
14492
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3684
—
FL
Enumeration date
12/10/2020
Last updated
12/10/2020
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