Individual
MRS. CONNIE MALOE WORK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2241 THORNTON TAYLOR PKWY, FAYETTEVILLE, TN 37334-3637
(931) 433-6456
Mailing address
1510 OLD ESTILL SPRINGS RD, TULLAHOMA, TN 37388-5503
(931) 454-0652
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4737
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4737
LICENSE NUMBER
TN
Enumeration date
03/01/2007
Last updated
07/08/2007
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