Provider Demographics
NPI:1700683513
Name:MALONE, PATRICIA MARY
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:MARY
Last Name:MALONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PARICIA
Other - Middle Name:MARY
Other - Last Name:PANZO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:117 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-3222
Mailing Address - Country:US
Mailing Address - Phone:717-688-9151
Mailing Address - Fax:
Practice Address - Street 1:117 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-3222
Practice Address - Country:US
Practice Address - Phone:717-688-9151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC017188101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health