Healthcare Provider Details

I. General information

NPI: 1649113721
Provider Name (Legal Business Name): ISABELLE MALLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5210 INDIAN HEAD HWY
OXON HILL MD
20745-2048
US

IV. Provider business mailing address

3805 EVANS TRAIL CT
BELTSVILLE MD
20705-3048
US

V. Phone/Fax

Practice location:
  • Phone: 202-560-3558
  • Fax:
Mailing address:
  • Phone: 240-755-5038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: