MEDICARE: MS. SONDRA M MALONE M.B.A.,LBSW

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	104100000X	Social Worker	6802078428	MI

General Provider Information

NPI Number	:	1821286550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SONDRA M MALONE M.B.A.,LBSW

Provider Business Mailing Address
First Line	:	5735 HEATHERFIELD CT
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48322-1332
Country	:	US
Telephone Number	:	586-741-9439
Fax Number	:

Provider Business Practice Location Address
First Line	:	5735 HEATHERFIELD CT
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48322-1332
Country	:	US
Telephone Number	:	586-741-9439
Fax Number	:

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

Provider Enumeration Date	:	10/09/2007
Last Update Date	:	11/24/2014

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