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Individual

MS. DENISE ANNE MALIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMHC

Contact information

Practice address
139 LARCH RD, CAMBRIDGE, MA 02138-3316
(617) 497-7370
Mailing address
46 EUSTIS ST APT 1, CAMBRIDGE, MA 02140-2205
(617) 868-5085
(617) 628-2595

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
3804
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LM0978
BLUE CROSS BLUE SHIELD
MA
Enumeration date
01/25/2007
Last updated
07/08/2007
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