Provider Demographics
NPI:1033247507
Name:MAMALIS, RACHAEL HOLSMAN (MS)
Entity Type:Individual
Prefix:MS
First Name:RACHAEL
Middle Name:HOLSMAN
Last Name:MAMALIS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 WOODLANE RD
Mailing Address - Street 2:SUITE 20
Mailing Address - City:WESTAMPTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08060-9654
Mailing Address - Country:US
Mailing Address - Phone:856-630-9865
Mailing Address - Fax:
Practice Address - Street 1:255 VISTA DR
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-6634
Practice Address - Country:US
Practice Address - Phone:856-630-9865
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker