Individual
DR. ANGELA R MALLMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
20700 WATERTOWN RD STE 100, WAUKESHA, WI 53186-1800
(414) 410-9905
Mailing address
PO BOX 61, OAK CREEK, WI 53154-0061
(414) 410-9905
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
103TC0700X
Clinical Psychologist
Primary
5291-57
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100031505
—
WI
Enumeration date
09/11/2009
Last updated
11/18/2024
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