Provider Demographics
NPI:1295213718
Name:DELGADO, MARIA I (RBT-18-59826)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:I
Last Name:DELGADO
Suffix:
Gender:F
Credentials:RBT-18-59826
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 S NAPERVILLE RD STE 110
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60189-5855
Mailing Address - Country:US
Mailing Address - Phone:630-779-9089
Mailing Address - Fax:
Practice Address - Street 1:1725 S NAPERVILLE RD STE 110
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60189-5855
Practice Address - Country:US
Practice Address - Phone:630-509-4911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-06
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL18-59826106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician