Provider Demographics
NPI:1598581530
Name:LAWRENCE, MALIA ANN (MA)
Entity type:Individual
Prefix:MRS
First Name:MALIA
Middle Name:ANN
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MISS
Other - First Name:MALIA
Other - Middle Name:ANN
Other - Last Name:AHRENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:15 LONGWOOD PL
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35504-7231
Mailing Address - Country:US
Mailing Address - Phone:205-512-1069
Mailing Address - Fax:205-512-1069
Practice Address - Street 1:15 LONGWOOD PL
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35504-7231
Practice Address - Country:US
Practice Address - Phone:205-512-1069
Practice Address - Fax:205-512-1069
Is Sole Proprietor?:No
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor