Healthcare Provider Details

I. General information

NPI: 1215831888
Provider Name (Legal Business Name): MADISON NICOLE MALONEY M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 CARLISLE ST STE 4
HANOVER PA
17331-2410
US

IV. Provider business mailing address

11 YORK ST STE 203
HANOVER PA
17331-3144
US

V. Phone/Fax

Practice location:
  • Phone: 717-465-8343
  • Fax:
Mailing address:
  • Phone: 717-465-8343
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSL017111
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: