| Doctor Name: | DR. SUSAN A. MALONEY |
| NPI Number: | 1790871259 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | 6301010320 |
| Business Practice Address: | 55 North Pond Dr. Suite 6 Walled Lake, MI - 48390 |
| Business Phone Number: | 2489268532 |
| Business Fax Number: | 2486691925 |
| Mailing Address: | 883 Laguna Dr., WOLVERINE LAKE |
| State: | MI |
| Postal Code: | 48390 |
| Phone Number: | 2486699569 |
| Fax Number: | 2486691925 |
| NPI Enumeration Date: | 10/04/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC2200X |
| License Number: | 6301010320 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical Child & Adolescent |
| Taxonomy Definition: | |