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Rathna Sree Mallela, MD,MPH
Child & Adolescent Psychiatry Physician in Janesville, Wisconsin
NPI 1194043554

Rathna Sree Mallela is a Child & Adolescent Psychiatry Physician based in Janesville, WI and is specialized in Child & Adolescent Psychiatry. Rathna Sree Mallela practices in Janesville, WI and has the professional credentials of MD,MPH. The NPI Number for Rathna Sree Mallela is 1194043554 and holds a License No. (Wisconsin).

The current practice location address for Rathna Sree Mallela is 2600 Humes Rd Ste 100, Janesville, WI and can be reached out via phone at 608-741-2117 and via fax at 608-758-5761.

Location: 2600 Humes Rd Ste 100, Janesville, WI, 53545-0491
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1194043554
Provider Name
Rathna Sree Mallela
Credential
MD,MPH
Provider Entity Type
Individual
Gender
Female
Address
2600 Humes Rd Ste 100, Janesville, WI, 53545-0491
Phone Number
608-741-2117
Fax Number
608-758-5761
Provider Enumeration Date
05/11/2010
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
K400258434-00084908 01 WI WI MEDICARE
1194043554 01 WI BCBSWI
1194043554 01 WI DEANHEALTH PLAN
1194043554 05 WI
K400258432-000054176 01 WI WI MEDICARE
MALLERAT 01 WI MERCYCARE INSURANCE
institution
Provider Business Practice Location Address Details
Address
2600 Humes Rd Ste 100
City
Janesville
State
Wisconsin
Zip
53545-0491
Phone Number
608-741-2117
Fax Number
608-758-5761
person
Provider Business Mailing Address Details
Address
2600 Humes Rd Ste 100
City
Janesville
State
Wisconsin
Zip
53545-0491
Phone Number
608-741-2117
Fax Number
608-758-5761
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Psychiatry & Neurology
Speciality
Child & Adolescent Psychiatry
Taxonomy
2084P0804X
License No.
64316-20 (Wisconsin)
Definition
Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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