| NPI | 1235389578 |
|---|---|
| Former Name | PHYLLIS MALONE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 080656) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 080188) |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2013-06-03 |