Organization
ALYSE MALMBORG THERAPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIARA EDWARDS (BILLING MANAGER)
(323) 404-5212
Entity
Organization
Contact information
Practice address
2155 W BELMONT AVE # 1071, CHICAGO, IL 60618-6471
(773) 250-7177
Mailing address
2155 W BELMONT AVE # 1071, CHICAGO, IL 60618-6471
(773) 250-7177
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/04/2025
Last updated
08/04/2025
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