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NPI Code Detail

MEDICARE: MARESIA RENE MALONE

MEDICARE: MARESIA RENE MALONE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst
2103K00000XBehavior AnalystNV

General Provider Information

NPI Number : 1497163315
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARESIA RENE MALONE
Provider Business Mailing Address
First Line : 3135 SALEEN CT
Second Line :
City : N LAS VEGAS
State : NV
Zip : 89031-0561
Country : US
Telephone Number : 702-904-0102
Fax Number :
Provider Business Practice Location Address
First Line : 3660 N RANCHO DR STE 113
Second Line :
City : LAS VEGAS
State : NV
Zip : 89130-3188
Country : US
Telephone Number : 702-982-2928
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2014
Last Update Date : 09/24/2015

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Directions to “ MARESIA RENE MALONE ” Practice Location

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