Individual
MR. MICHAEL DAVID MALONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
100 COURT ST, TUPELO, MS 38804-3900
(662) 844-4254
Mailing address
1305 BAKER RD, LAKE CORMORANT, MS 38641-9217
(662) 386-7336
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0506
MS
Other
Enumeration date
05/22/2012
Last updated
05/22/2012
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