Malloy, Blake

Malloy, Blake is an individual health care provider with primary practice located at 13603 80Th Cir N , Maple Grove MN 55369-8961. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Malloy, Blake can be contacted via phone (763) 274-3120.

Contact Information

Primary practice address
13603 80Th Cir N Maple Grove MN 55369-8961
Phone: (763) 274-3120
Fax: (763) 274-3121
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1033636519
LBN Legal business name Malloy, Blake
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 25th, 2017
Last updated Aug 25th, 2017 - about 7 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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