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General NPI Number Information
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NPI Number | 1902070477
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Entity Type | Individual
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Provider Name | JOSEPH C. MALLET PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 04/16/2008
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Last Update Date | 04/16/2008
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Provider Practice Location Address
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Address Line | 1390 S DIXIE HWY SUITE 1307
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City | CORAL GABLES
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State | FL
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Zip | 33146-2927
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Country | US
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Telephone | 305-665-3512
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Fax | 305-663-3331
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Provider Business Mailing Address
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Address Line | 1390 S DIXIE HWY SUITE 1307
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City | CORAL GABLES
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State | FL
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Zip | 33146-2927
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Country | US
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Telephone | 305-665-3512
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Fax | 305-663-3331
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY0006306
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | PY0006306
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License Number State | FL
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