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Sara Wicks Malone

NPI Registration Record

Provider / OrganizationNPIDate Certified
SARA WICKS MALONE16690994042020-06-27
Entity TypeIndividual
Provider Name Sara Wicks Malone LCSW
Other Provider Name Sara Wicks
Practice Office Address1123 BROADWAY STE 319
NEW YORK, NY US
Practice Office Telephone9174788534
Mailing Address391 ADELPHI ST APT C
BROOKLYN, NY 112381560 US
Business Telephone9174788534
HPT Codes
CodeLicense NoState
1041C0700X PRIMARY076537-1 NY
OPI Codes

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