Organization
SHILOH VALLEY CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDERLY MALIWA (PRESIDENT/CEO)
(765) 326-0148
Entity
Organization
Contact information
Practice address
707 WHITLOCK AVE SW, MARIETTA, GA 30064-3000
(765) 326-0148
Mailing address
707 WHITLOCK AVE SW, MARIETTA, GA 30064-3000
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/09/2026
Last updated
04/09/2026
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