Provider Demographics
NPI:1821233719
Name:MALONE, LARHONDA CARNELL
Entity Type:Individual
Prefix:MS
First Name:LARHONDA
Middle Name:CARNELL
Last Name:MALONE
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 1:1406 PECAN ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71202-2950
Mailing Address - Country:US
Mailing Address - Phone:318-398-7160
Mailing Address - Fax:
Practice Address - Street 1:1406 PECAN ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71202-2950
Practice Address - Country:US
Practice Address - Phone:318-398-7160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-08
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver