Provider Demographics
NPI:1386050888
Name:MALDONADO, MARIA C (LBSW)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:C
Last Name:MALDONADO
Suffix:
Gender:F
Credentials:LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 ALLENDE ST
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-5047
Mailing Address - Country:US
Mailing Address - Phone:956-635-8350
Mailing Address - Fax:
Practice Address - Street 1:602 ALLENDE ST
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-5047
Practice Address - Country:US
Practice Address - Phone:956-635-8350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-03
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33052171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator