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1689653743
IVY J MALLISHAM
COLUMBUS, GA
NPI
1689653743
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: GA PSY001132)
Enumeration Date
2006-01-16
Last Update Date
2007-07-09
Business Address
Dr. IVY J MALLISHAM PSY.D.
5041 WARM SPRINGS RD SUITE B
COLUMBUS, GA 31909-6938
Phone number: 706-569-9199
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Mailing Address
Dr. IVY J MALLISHAM PSY.D.
5041 WARM SPRINGS RD SUITE B
COLUMBUS, GA 31909-6938
Phone number: 706-569-9199
Copy
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