Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | 178.006042 | IL |
NPI | 1003041807 |
---|---|
Provider Name | Ms. Maura L Maloney |
First Address | Oak Forest, IL 60452-2904 |
Second Address | Oak Forest, IL 60452-2904 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2009 |
Last Update Date | 21/05/2009 |