Provider Demographics
NPI:1568217529
Name:BASDEO, MALINI (PSYD)
Entity Type:Individual
Prefix:
First Name:MALINI
Middle Name:
Last Name:BASDEO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2111 WISCONSIN AVE NW APT 421
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-2226
Mailing Address - Country:US
Mailing Address - Phone:203-885-6395
Mailing Address - Fax:
Practice Address - Street 1:2111 WISCONSIN AVE NW APT 421
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-2226
Practice Address - Country:US
Practice Address - Phone:203-885-6395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY200001280103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical