| Doctor Name: | VENKATESWARA RAO MALINENI |
| NPI Number: | 1265467682 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | VM053562 |
| Business Practice Address: | 215 North Ave St Joseph Specialty Hospital 215 Mt Clemens, MI - 48045 |
| Business Phone Number: | 5864669889 |
| Business Fax Number: | 5864669972 |
| Mailing Address: | 5341 Provincial Dr, BLOOMFIELD HILLS |
| State: | MI |
| Postal Code: | 48302 |
| Phone Number: | 8884953999 |
| Fax Number: | 5864669972 |
| NPI Enumeration Date: | 07/12/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | VM053562 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |