Healthcare Provider Details

I. General information

NPI: 1255263265
Provider Name (Legal Business Name): LAURA MALONEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18464 MEYERS RD
DETROIT MI
48235-1307
US

IV. Provider business mailing address

18464 MEYERS RD
DETROIT MI
48235-1307
US

V. Phone/Fax

Practice location:
  • Phone: 734-373-4528
  • Fax:
Mailing address:
  • Phone: 734-373-4528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number230014587400509
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: