Provider Demographics
NPI:1235964693
Name:MALONE, BOBBIE
Entity type:Individual
Prefix:
First Name:BOBBIE
Middle Name:
Last Name:MALONE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4540 COOPER RD STE 200
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-5649
Mailing Address - Country:US
Mailing Address - Phone:513-618-8300
Mailing Address - Fax:
Practice Address - Street 1:4540 COOPER RD STE 200
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-5649
Practice Address - Country:US
Practice Address - Phone:513-618-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator