Provider Demographics
NPI:1295567386
Name:MEALY, MALIAKA
Entity type:Individual
Prefix:
First Name:MALIAKA
Middle Name:
Last Name:MEALY
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 1:4119 GAULT PL NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-3537
Mailing Address - Country:US
Mailing Address - Phone:301-377-9252
Mailing Address - Fax:
Practice Address - Street 1:4119 GAULT PL NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-3537
Practice Address - Country:US
Practice Address - Phone:301-377-9252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-16
Last Update Date:2024-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator