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General NPI Number Information
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NPI Number | 1619884392
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Entity Type | Individual
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Provider Name | XYRYL MARIE MALIT
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Gender | Female
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Dates
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Enumeration Date | 08/26/2026
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Last Update Date | 08/26/2026
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Provider Practice Location Address
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Address Line | 18040 SAN BERNARDINO AVE
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City | BLOOMINGTON
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State | CA
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Zip | 92316-1643
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Country | US
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Telephone | 909-580-5025
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Fax |
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Provider Business Mailing Address
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Address Line | 850 E WASHINGTON ST
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City | COLTON
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State | CA
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Zip | 92324-8101
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Country | US
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Telephone | 909-580-5002
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP31139
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License Number State | CA
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