Provider Demographics
NPI:1376011049
Name:MALOY THERAPEUTIC ALLIANCE INC
Entity Type:Organization
Organization Name:MALOY THERAPEUTIC ALLIANCE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:MALOY-MATUZIK
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:708-822-8623
Mailing Address - Street 1:1381 RENNET DR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60565-1211
Mailing Address - Country:US
Mailing Address - Phone:708-822-8623
Mailing Address - Fax:
Practice Address - Street 1:1827 WALDEN OFFICE SQ STE 510
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4278
Practice Address - Country:US
Practice Address - Phone:708-822-8623
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-11
Last Update Date:2018-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty