Provider Demographics
NPI:1811144009
Name:MALOY, BRENDA KAY (MS, LPC)
Entity type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:KAY
Last Name:MALOY
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6703 MARY TODD DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-2848
Mailing Address - Country:US
Mailing Address - Phone:210-561-4487
Mailing Address - Fax:
Practice Address - Street 1:6703 MARY TODD DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-2848
Practice Address - Country:US
Practice Address - Phone:210-561-4487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-19
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12028101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional