Provider Demographics
NPI:1225309719
Name:MALONE-SMITH, JACINTHA YVETTE (MS)
Entity Type:Individual
Prefix:
First Name:JACINTHA
Middle Name:YVETTE
Last Name:MALONE-SMITH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7422 PAGE RANCH CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89131-3244
Mailing Address - Country:US
Mailing Address - Phone:702-596-1036
Mailing Address - Fax:
Practice Address - Street 1:3435 W CRAIG RD
Practice Address - Street 2:SUITE A
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-5115
Practice Address - Country:US
Practice Address - Phone:702-750-0377
Practice Address - Fax:702-538-7928
Is Sole Proprietor?:No
Enumeration Date:2012-01-16
Last Update Date:2012-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health