Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
Y | 101YP2500X | Professional Counselor | 8899 | MA |
NPI | 1003240565 |
---|---|
Provider Name | James M Malone |
First Address | South Chatham, MA 02659-1306 |
Second Address | South Chatham, MA 02659-1306 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2013 |
Last Update Date | 30/11/2021 |