Provider Demographics
NPI:1942013255
Name:MALONE, SOFIA
Entity type:Individual
Prefix:
First Name:SOFIA
Middle Name:
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 1:35 TODD ST UNIT 206
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-1547
Mailing Address - Country:US
Mailing Address - Phone:860-970-9701
Mailing Address - Fax:
Practice Address - Street 1:35 TODD ST UNIT 206
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-1547
Practice Address - Country:US
Practice Address - Phone:860-970-9701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL61603293235Z00000X
RISP01814235Z00000X
MASLP101207235Z00000X
IN22009014A235Z00000X
CT007040235Z00000X
WVSLP-2605235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist