Mallisham, Ivy J

Mallisham, Ivy J is an sole proprietor health care provider with primary practice located at 5041 Warm Springs Rd Suite B, Columbus GA 31909-6938. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Mallisham, Ivy J can be contacted via phone (706) 569-9199.

Contact Information

Primary practice address
5041 Warm Springs Rd Suite B Columbus GA 31909-6938
Fax: (706) 569-8990
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY001132 Georgia

Profile Details

NPI number 1689653743
LBN Legal business name Mallisham, Ivy J
Credentials PSY.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 16th, 2006
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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