Healthcare Provider Details

I. General information

NPI: 1891900825
Provider Name (Legal Business Name): ROBERT DALY MALAIN M.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ROBERT DALY MALAIN II M.A.

II. Dates (important events)

Enumeration Date: 05/12/2007
Last Update Date: 03/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

819 WATER ST SUITE 300
KERRVILLE TX
78028-5333
US

IV. Provider business mailing address

819 WATER ST SUITE 300
KERRVILLE TX
78028-5333
US

V. Phone/Fax

Practice location:
  • Phone: 830-258-5430
  • Fax: 830-792-5771
Mailing address:
  • Phone: 830-258-5430
  • Fax: 830-792-5771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number13358
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number004770
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: