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NPI Code Detail

MEDICARE: LATASHA MALONE

MEDICARE: LATASHA 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
1101YA0400XAddiction (Substance Use Disorder) Counselor37LC00163600NJ

General Provider Information

NPI Number : 1043639172
Entity Type Code : Individual
Provider Name (Legal Business Name) : LATASHA MALONE
Provider Business Mailing Address
First Line : 2713 LANCASTER AVE
Second Line :
City : WILMINGTON
State : DE
Zip : 19805-5220
Country : US
Telephone Number : 302-656-2348
Fax Number :
Provider Business Practice Location Address
First Line : 2713 LANCASTER AVE
Second Line :
City : WILMINGTON
State : DE
Zip : 19805-5220
Country : US
Telephone Number : 302-656-2348
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2014
Last Update Date : 02/08/2026

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1467502419 — SUSAN P BECKMAN
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Directions to “ LATASHA MALONE ” Practice Location

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