Provider Demographics
NPI:1265681936
Name:MALANGA, PAUL R (PHD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:R
Last Name:MALANGA
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9395 GARDEN WOODS DR
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-4729
Mailing Address - Country:US
Mailing Address - Phone:605-376-3334
Mailing Address - Fax:
Practice Address - Street 1:9395 GARDEN WOODS DR
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016-4729
Practice Address - Country:US
Practice Address - Phone:605-376-3334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1-07-3869103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental Disabilities