Evelyn Mallea, Chtd

NPI 1770671372

Information of Evelyn Mallea, Chtd

The NPI 1770671372 is an Organization type. NPI No 1770671372 belongs to Evelyn Mallea, Chtd. Evelyn Mallea, Chtd specializes in Clinical. is practising at 1002 Shoshone St E, Twin Falls, Idaho 83301. You can also contact him via phone number (208) 734-7714.

Practice address located

  • 1002 Shoshone St E
  • Twin Falls, Idaho 83301
  • (208) 734-7714
  • (208) 734-7714

Mailling address located

  • 1002 Shoshone St E
  • Twin Falls, Idaho 83301
  • (208) 734-7714
  • (208) 735-8537
NPI No 1770671372
Primary Taxonomy
Authorized Official
Specialty of the provider
PrimaryTaxonomy CodeClassificationLicense NumberLicense State
Yes1041C0700XClinicalLCSW779Idaho
Identifier for this provider
StateIdentifierTypeIssuer
ID1692000Medicare ID-Type Unspecifiedn/a
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