Provider Demographics
NPI:1558166652
Name:MALAWY, WENDY MARLENE (MSPT)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:MARLENE
Last Name:MALAWY
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2473 BOARDWALK PL
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63129-4853
Mailing Address - Country:US
Mailing Address - Phone:636-579-9127
Mailing Address - Fax:
Practice Address - Street 1:2909 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63125-4062
Practice Address - Country:US
Practice Address - Phone:314-894-9008
Practice Address - Fax:314-894-1232
Is Sole Proprietor?:No
Enumeration Date:2025-02-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO112025225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist