| Doctor Name: | ELIZABETH J MALCOM |
| NPI Number: | 1003045048 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMHC |
| License Number: | 39002081A |
| Business Practice Address: | 8401 Harcourt Rd Indianapolis, IN - 462602036 |
| Business Phone Number: | 3173384600 |
| Business Fax Number: | 3173384890 |
| Mailing Address: | 10330 N Meridian St, INDIANAPOLIS |
| State: | IN |
| Postal Code: | 462901024 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 07/13/2009 |
| NPI Last Update Date: | 07/13/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 39002081A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |