Provider Demographics
NPI:1942530019
Name:CUMMINGS, MALEAH D (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MALEAH
Middle Name:D
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 W US HIGHWAY 2
Mailing Address - Street 2:
Mailing Address - City:WAKEFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:49968-9515
Mailing Address - Country:US
Mailing Address - Phone:906-229-6120
Mailing Address - Fax:
Practice Address - Street 1:103 W US HIGHWAY 2
Practice Address - Street 2:
Practice Address - City:WAKEFIELD
Practice Address - State:MI
Practice Address - Zip Code:49968-9515
Practice Address - Country:US
Practice Address - Phone:906-229-6120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-12
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2712-57103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical