MEDICARE: NICOLE MALONEY

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
1	1041S0200X	School Social Worker	11344	MD

General Provider Information

NPI Number	:	1164989166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE MALONEY

Provider Business Mailing Address
First Line	:	2419 APPALOOSA WAY
Second Line	:
City	:	FINKSBURG
State	:	MD
Zip	:	21048-1622
Country	:	US
Telephone Number	:	410-598-1083
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 COCKEYS MILL RD
Second Line	:
City	:	REISTERSTOWN
State	:	MD
Zip	:	21136-1283
Country	:	US
Telephone Number	:	410-887-1114
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2019
Last Update Date	:	02/26/2019

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Directions to “ NICOLE MALONEY ” Practice Location

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