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Individual

DOMONIQUE MALLOY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCPC

Contact information

Practice address
7201 BALTIMORE ANNAPOLIS BLVD, GLEN BURNIE, MD 21061-2637
(410) 766-7300
Mailing address
PO BOX 2003, GREENBELT, MD 20768-2003
(410) 766-7300

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
MD

Other

Enumeration date
02/25/2018
Last updated
05/13/2026
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