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Individual

DR. JANA BARBARA MALLIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LBS

Contact information

Practice address
53 DEWEY RD, CHELTENHAM, PA 19012-1413
(215) 635-1110
(215) 635-5224
Mailing address
53 DEWEY RD, CHELTENHAM, PA 19012-1413
(215) 635-1110
(215) 635-5224

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH000549
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
BH000549
COMMONWEALTH OF PA, DEPT OF STATE, BUREAU OF PROFESSIONAL & OCCUPATIONAL AFFAIRS
PA
Enumeration date
06/19/2014
Last updated
06/19/2014
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