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General NPI Number Information
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NPI Number | 1043633514
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Entity Type | Individual
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Provider Name | MELISSA L MALONE MSW
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Gender | Female
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Dates
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Enumeration Date | 02/03/2014
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Last Update Date | 02/03/2014
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Provider Practice Location Address
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Address Line | 2711 W 15TH ST
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City | PANAMA CITY
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State | FL
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Zip | 32401-1366
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Country | US
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Telephone | 850-769-6002
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Fax |
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Provider Business Mailing Address
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Address Line | 311 JOHNSTON ST APT 2
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City | TALLAHASSEE
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State | FL
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Zip | 32303-6213
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Country | US
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Telephone | 850-591-4188
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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