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1811666175
BASAVANTH MALLADI
FPO, AP
NPI
1811666175
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: UT 12970271-2501)
Enumeration Date
2021-09-09
Last Update Date
2023-08-22
Business Address
BASAVANTH MALLADI
PSC 476 BOX 25
FPO, AP 96322-0001
Phone number: 315-252-2071
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Mailing Address
BASAVANTH MALLADI
PSC 476 BOX 25
FPO, AP 96322-0001
Phone number: 315-252-8872
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