Individual
SANDHYA MALLYA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LLP
Contact information
Practice address
5111 AUTO CLUB DR, #120, DEARBORN, MI 48126-2749
(313) 583-0735
(313) 583-0751
Mailing address
28000 DEQUINDRE RD, WARREN, MI 48092-2468
(586) 753-0405
(586) 753-0404
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301011885
MI
Other
Enumeration date
07/11/2006
Last updated
07/08/2007
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