Provider Demographics
NPI:1336636117
Name:BELTRAN, MARANYELY
Entity Type:Individual
Prefix:
First Name:MARANYELY
Middle Name:
Last Name:BELTRAN
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 1:9627 PHILADELPHIA RD STE 160
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-4157
Mailing Address - Country:US
Mailing Address - Phone:410-780-5203
Mailing Address - Fax:
Practice Address - Street 1:9627 PHILADELPHIA RD STE 160
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:MD
Practice Address - Zip Code:21237-4157
Practice Address - Country:US
Practice Address - Phone:410-780-5203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-17
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD27692104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker