Individual
ARIEL ANASTASHIA MALONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
120 N WALNUT ST, JEFFERSON, TX 75657-1934
(903) 665-6131
Mailing address
PO BOX 901, JEFFERSON, TX 75657-0901
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
349080
TX
Other
Enumeration date
09/24/2019
Last updated
09/24/2019
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