Provider Demographics
NPI:1013282409
Name:MALOKO, MELISSA (QP)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:
Last Name:MALOKO
Suffix:
Gender:F
Credentials:QP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CAPITOLA DR
Mailing Address - Street 2:SUITE 310
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-4496
Mailing Address - Country:US
Mailing Address - Phone:919-474-6400
Mailing Address - Fax:
Practice Address - Street 1:100 CAPITOLA DR
Practice Address - Street 2:SUITE 310
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-4496
Practice Address - Country:US
Practice Address - Phone:919-474-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-19
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health