Provider Demographics
NPI:1598437444
Name:PRESTON, MALOREE NADINE
Entity Type:Individual
Prefix:
First Name:MALOREE
Middle Name:NADINE
Last Name:PRESTON
Suffix:
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 1:160 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-2506
Mailing Address - Country:US
Mailing Address - Phone:740-253-9220
Mailing Address - Fax:
Practice Address - Street 1:38 S PAINT ST
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-3238
Practice Address - Country:US
Practice Address - Phone:740-851-4517
Practice Address - Fax:740-851-4515
Is Sole Proprietor?:No
Enumeration Date:2021-09-29
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHTH252703171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator