Provider Demographics
NPI:1326672684
Name:MALDONADO, MARILEEN Z (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARILEEN
Middle Name:Z
Last Name:MALDONADO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:VILLAS DE CASTRO
Mailing Address - Street 2:T5 CALLE 19
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725-4649
Mailing Address - Country:US
Mailing Address - Phone:787-586-0238
Mailing Address - Fax:
Practice Address - Street 1:2 CALLE ACERINA
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-2076
Practice Address - Country:US
Practice Address - Phone:787-493-9360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-26
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6505103TC1900X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling