Provider Demographics
NPI:1306734223
Name:MALDONADO GARCIA, DEVANY NATALY
Entity type:Individual
Prefix:
First Name:DEVANY
Middle Name:NATALY
Last Name:MALDONADO GARCIA
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 1:4149 LAKE LYNN DR APT 305
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-3453
Mailing Address - Country:US
Mailing Address - Phone:704-960-8402
Mailing Address - Fax:
Practice Address - Street 1:3001 ACADEMY RD STE 200
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-6245
Practice Address - Country:US
Practice Address - Phone:984-365-9330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-27
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23-278568106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician