Individual
HENRY WILLIAM MALLETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
40 SMART ST, WALTHAM, MA 02451-2158
(617) 599-2202
Mailing address
40 SMART ST, WALTHAM, MA 02451-2158
(617) 599-2202
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LICSW127052
MA
Other
Enumeration date
02/28/2024
Last updated
02/28/2024
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