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General NPI Number Information
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NPI Number | 1619923166
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Entity Type | Individual
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Provider Name | CHRISTINE MARIE MALONE PH.D.
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Gender | Female
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 04/22/2021
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Provider Practice Location Address
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Address Line | 554 GREEN TREE CV STE 101A
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City | COLLIERVILLE
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State | TN
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Zip | 38017-2551
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Country | US
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Telephone | 901-619-7173
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Fax | 901-754-9279
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Provider Business Mailing Address
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Address Line | 11585 CHARLESBASS CV
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City | EADS
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State | TN
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Zip | 38028-6919
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Country | US
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Telephone | 901-867-7480
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 34-557
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | P1962
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License Number State | TN
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