Provider Demographics
NPI:1609447010
Name:BATTLES, MALCOLM MALIK (PSR)
Entity Type:Individual
Prefix:
First Name:MALCOLM
Middle Name:MALIK
Last Name:BATTLES
Suffix:
Gender:M
Credentials:PSR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15100 ELLA BLVD APT 1603
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-7037
Mailing Address - Country:US
Mailing Address - Phone:603-858-1227
Mailing Address - Fax:
Practice Address - Street 1:15100 ELLA BLVD APT 1603
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-7037
Practice Address - Country:US
Practice Address - Phone:603-858-1227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-07
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst