Individual
MS. SUSAN REBECCA MALOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1410 S TELEGRAPH RD, BLOOMFIELD HILLS, MI 48302-0046
(248) 456-8153
Mailing address
1410 S TELEGRAPH RD, BLOOMFIELD HILLS, MI 48302
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
4704180080
MI
Other
Enumeration date
06/14/2017
Last updated
06/14/2017
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