Provider Demographics
NPI:1497113799
Name:MALDONADO, LINDA
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:MALDONADO
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 1:528 E MAIN ST
Mailing Address - Street 2:SUITE W
Mailing Address - City:JOHN DAY
Mailing Address - State:OR
Mailing Address - Zip Code:97845-1289
Mailing Address - Country:US
Mailing Address - Phone:541-575-7146
Mailing Address - Fax:541-575-1411
Practice Address - Street 1:528 E MAIN ST
Practice Address - Street 2:SUITE W
Practice Address - City:JOHN DAY
Practice Address - State:OR
Practice Address - Zip Code:97845-1289
Practice Address - Country:US
Practice Address - Phone:541-575-7146
Practice Address - Fax:541-575-1411
Is Sole Proprietor?:No
Enumeration Date:2016-02-02
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health