Provider Demographics
NPI:1699883330
Name:MALONEY, MICHELLE M (AUD)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:M
Last Name:MALONEY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4320 SUWANEE DAM RD
Mailing Address - Street 2:STE 200
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-1918
Mailing Address - Country:US
Mailing Address - Phone:404-297-4230
Mailing Address - Fax:678-710-9430
Practice Address - Street 1:4320 SUWANEE DAM RD
Practice Address - Street 2:STE 200
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-1918
Practice Address - Country:US
Practice Address - Phone:404-297-4230
Practice Address - Fax:678-710-9430
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1222231H00000X
GAAUD003817231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist