Individual
DR. MALLORY L MALKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504
(210) 916-4141
(210) 292-7127
Mailing address
PO BOX 36, PETAL, MS 39465-0036
(267) 640-8472
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
1643
LA
103TC0700X
Clinical Psychologist
Primary
55980
MS
Other
Enumeration date
06/19/2012
Last updated
05/03/2024
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