Individual
MS. DESIREE DIANNE MALAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
304 W WASHINGTON AVE, RICHLAND, MO 65556-7101
(877) 406-2662
Mailing address
PO BOX 777, RICHLAND, MO 65556-0777
(877) 406-2662
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2013006416
MO
Other
Enumeration date
03/11/2013
Last updated
05/17/2022
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