Individual
DR. KEAJUANIS MALENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
16162 ELLIS AVE, SUITE 1, SOUTH HOLLAND, IL 60473-1700
(817) 793-1011
Mailing address
110 LAWRENCE LN, MATTESON, IL 60443-2933
(817) 793-1011
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
071008853
IL
Other
Enumeration date
07/11/2014
Last updated
07/21/2014
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