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Individual

DR. LEANNE FOLI MALLOY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D., HSPP

Contact information

Practice address
3200 COLD SPRING RD, INDIANAPOLIS, IN 46222-1960
(317) 955-6150
Mailing address
6792 BLACK OAK WEST CT, AVON, IN 46123-8014
(317) 272-1032

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20040634
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100252690
IN
01
11348711
CAQH USER NAME
IN
Enumeration date
05/16/2006
Last updated
07/08/2007
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