Healthcare Provider Details

I. General information

NPI: 1932067964
Provider Name (Legal Business Name): WILLIAM BRANDON MALLETTE MA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2026
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4958 VALLEYDALE RD STE 251
HOOVER AL
35242-7723
US

IV. Provider business mailing address

4958 VALLEYDALE RD STE 251
HOOVER AL
35242-7723
US

V. Phone/Fax

Practice location:
  • Phone: 205-775-0705
  • Fax:
Mailing address:
  • Phone: 205-775-0705
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: