Provider Demographics
NPI:1346231206
Name:MALONE, MELODY ANNE (PT)
Entity Type:Individual
Prefix:MS
First Name:MELODY
Middle Name:ANNE
Last Name:MALONE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4924 BRANDENBURG LN
Mailing Address - Street 2:
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-2015
Mailing Address - Country:US
Mailing Address - Phone:972-625-6283
Mailing Address - Fax:972-625-9834
Practice Address - Street 1:4924 BRANDENBURG LN
Practice Address - Street 2:
Practice Address - City:THE COLONY
Practice Address - State:TX
Practice Address - Zip Code:75056-2015
Practice Address - Country:US
Practice Address - Phone:972-625-6283
Practice Address - Fax:972-625-9834
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX124792174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist