Provider Demographics
NPI:1134795560
Name:MALOY, GINGER L (RMHCI)
Entity type:Individual
Prefix:
First Name:GINGER
Middle Name:L
Last Name:MALOY
Suffix:
Gender:F
Credentials:RMHCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4317 IRIS ST N
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-3985
Mailing Address - Country:US
Mailing Address - Phone:727-480-3230
Mailing Address - Fax:
Practice Address - Street 1:4317 IRIS ST N
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-3985
Practice Address - Country:US
Practice Address - Phone:727-480-3230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-27
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MH22546101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health