Provider Demographics
NPI:1124306857
Name:MALINOWSKI, JUDITH M (LLP)
Entity type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:M
Last Name:MALINOWSKI
Suffix:
Gender:F
Credentials:LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:26850 PROVIDENCE PKWY
Mailing Address - Street 2:SUITE 410
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48374-1213
Mailing Address - Country:US
Mailing Address - Phone:248-465-4335
Mailing Address - Fax:248-465-4535
Practice Address - Street 1:26850 PROVIDENCE PKWY
Practice Address - Street 2:SUITE 410
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48374-1213
Practice Address - Country:US
Practice Address - Phone:248-465-4335
Practice Address - Fax:248-465-4535
Is Sole Proprietor?:No
Enumeration Date:2011-07-29
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301007252103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist