Individual
GREGORY V MALLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D
Contact information
Practice address
1870 LEONARD ST SE, GRAND RAPIDS, MI 49505-5650
(616) 956-1122
(616) 956-8033
Mailing address
1870 LEONARD STREET SE, GRAND RAPIDS, MI 49505-5650
(616) 956-1122
(616) 956-8033
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301015440
MI
Other
Enumeration date
06/07/2013
Last updated
06/07/2013
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