Individual
MS. KELLY MARIE MALONE V
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
884 W PARK AVE, PORT TOWNSEND, WA 98368-2273
(360) 385-0321
Mailing address
PO BOX 565, PORT TOWNSEND, WA 98368-0565
(360) 385-0321
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101-YM0800X
COUNSELOR-MENTAL HEALTH
CA
01
—
1194800813
CASE MANAGER
WA
Enumeration date
10/25/2006
Last updated
11/08/2022
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