Individual
SANDRA S. MALONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
19106 INGLEWOOD AVE, ROCKY RIVER, OH 44116-2849
(440) 666-5731
Mailing address
23841 FRANK ST, NORTH OLMSTED, OH 44070-1378
(440) 666-5731
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0066432
—
OH
Enumeration date
04/07/2021
Last updated
04/07/2021
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