Doctor Name: | NANDINI MALLA |
NPI Number: | 1316341878 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC-SLP |
License Number: | 073364 |
Business Practice Address: | 200 S 8th Ave E Newton, IA - 502084762 |
Business Phone Number: | 6417927440 |
Business Fax Number: | |
Mailing Address: | 100 35th St, DES MOINES |
State: | IA |
Postal Code: | 503124509 |
Phone Number: | 9722071578 |
Fax Number: | |
NPI Enumeration Date: | 10/13/2014 |
NPI Last Update Date: | 10/13/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 073364 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |