Provider Demographics
NPI:1306729686
Name:MALONE, PRINCESS MELKALI VERNAY
Entity type:Individual
Prefix:
First Name:PRINCESS
Middle Name:MELKALI VERNAY
Last Name:MALONE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5441 DURHAM AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76114-4532
Mailing Address - Country:US
Mailing Address - Phone:817-832-5858
Mailing Address - Fax:
Practice Address - Street 1:19 W 24TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-3203
Practice Address - Country:US
Practice Address - Phone:817-832-5858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-25
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician