Individual
PAMELA MALLOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, NCC, LPC
Contact information
Practice address
166 MAIN ST, MATAWAN, NJ 07747-3104
(732) 290-9040
(732) 566-0433
Mailing address
1 PAINTED WAGON RD, HOLMDEL, NJ 07733-2725
(732) 706-1461
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
37PC00326900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37PC00326900
LPC
NJ
Enumeration date
12/20/2006
Last updated
07/08/2007
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