Individual
MS. AUDREY LORRAINE MALCOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
83 E MAIN ST, BAY SHORE, NY 11706-8305
(347) 645-7202
Mailing address
229-47 129TH AVENUE, SPRINGFIELD GARDENS, NY 11413-2209
(347) 645-7202
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
077775
NY
Other
Enumeration date
10/14/2010
Last updated
03/03/2020
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