Provider Demographics
NPI:1952533242
Name:CHAUDHERY-MALGERI, MALASRI (PHD)
Entity Type:Individual
Prefix:DR
First Name:MALASRI
Middle Name:
Last Name:CHAUDHERY-MALGERI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1060 W 14 MILE RD
Mailing Address - Street 2:
Mailing Address - City:CLAWSON
Mailing Address - State:MI
Mailing Address - Zip Code:48017-1409
Mailing Address - Country:US
Mailing Address - Phone:248-912-7434
Mailing Address - Fax:
Practice Address - Street 1:1060 W 14 MILE RD
Practice Address - Street 2:SYNERGY THERAPY CENTER
Practice Address - City:CLAWSON
Practice Address - State:MI
Practice Address - Zip Code:48017-1409
Practice Address - Country:US
Practice Address - Phone:248-912-7434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-20
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301012658103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist