Individual
ALEXANDER SCOTT MALM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1300 W LODI AVE, G-2, LODI, CA 95242-3000
(209) 334-2126
Mailing address
1300 W LODI AVE, G-2, LODI, CA 95242-3000
(209) 334-2126
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
03/14/2013
Last updated
03/14/2013
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