Provider Demographics
NPI:1265988869
Name:JONES, MARIA (PHD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:MALACHOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:23411 JEFFERSON AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48080-1949
Mailing Address - Country:US
Mailing Address - Phone:586-299-1123
Mailing Address - Fax:586-279-3864
Practice Address - Street 1:23411 JEFFERSON AVE STE 100
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48080-1949
Practice Address - Country:US
Practice Address - Phone:586-299-1123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301018789103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2846675Medicaid