Provider Demographics
NPI:1003364837
Name:MALONE, KAMIA LASHAY I
Entity Type:Individual
Prefix:
First Name:KAMIA
Middle Name:LASHAY
Last Name:MALONE
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 CABIN CREEK RD
Mailing Address - Street 2:
Mailing Address - City:SALINE
Mailing Address - State:LA
Mailing Address - Zip Code:71070-2341
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:560 CABIN CREEK RD
Practice Address - Street 2:
Practice Address - City:SALINE
Practice Address - State:LA
Practice Address - Zip Code:71070-2341
Practice Address - Country:US
Practice Address - Phone:318-583-2006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-21
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst