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NPI Code Detail

MEDICARE: LEAH MALOOF

MEDICARE: LEAH MALOOF
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
1101YP2500XProfessional CounselorLPC008782GA

General Provider Information

NPI Number : 1952767428
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEAH MALOOF
Provider Business Mailing Address
First Line : 104 PILGRIM VILLAGE DR STE 300
Second Line :
City : CUMMING
State : GA
Zip : 30040-9232
Country : US
Telephone Number : 470-296-1830
Fax Number : 770-406-8872
Provider Business Practice Location Address
First Line : 104 PILGRIM VILLAGE DR STE 300
Second Line :
City : CUMMING
State : GA
Zip : 30040-9232
Country : US
Telephone Number : 470-296-1830
Fax Number : 770-406-8872
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2016
Last Update Date : 03/09/2022

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Directions to “ LEAH MALOOF ” Practice Location

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