Individual
JENNIFER ELAINE MALONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A. TEMP LIC #1
Contact information
Practice address
824 CROSS LANES DR, CROSS LANES, WV 25313-1338
(304) 759-9835
(304) 759-9839
Mailing address
824 CROSS LANES DR, CROSS LANES, WV 25313-1338
(304) 759-9835
(304) 759-9839
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810001251
—
WV
Enumeration date
10/30/2017
Last updated
10/30/2017
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