Individual
JHARNA MALLIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CP
Contact information
Practice address
11204 WAPLES MILL RD, FAIRFAX, VA 22030-6036
(703) 218-8500
(703) 359-0463
Mailing address
11204 WAPLES MILL RD, FAIRFAX, VA 22030-6036
(703) 218-8500
(703) 359-0463
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810004515
VA
Other
Enumeration date
02/11/2012
Last updated
02/13/2012
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