IndividualActive
Brian Malliett, EDD
NPI 1316456536 · School Psychologist · Bourbonnais, IL
Provider details
- NPI number
- 1316456536
- Entity type
- Individual
- Primary specialty
- School PsychologistBehavioral Health & Social Service Providers
- Credential
- EDD
- Sex
- Male
- Sole proprietor
- Yes
- License
- 1907241 (IL)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Practice location
1466 Hunters Run Dr
Bourbonnais, IL 60914-4520
Phone: (815) 474-9550
Approximate (ZIP-level) locationGet directions
Mailing address
1466 Hunters Run Dr
Bourbonnais, IL 60914-4520
Registry dates
- Enumerated
- 2017-09-20
- Last updated
- 2022-07-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.