Provider Demographics
NPI:1497929533
Name:PEDRAZA, MARIA E (MSW)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:E
Last Name:PEDRAZA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 LINCOLNWAY E
Mailing Address - Street 2:
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46544-2016
Mailing Address - Country:US
Mailing Address - Phone:574-255-4976
Mailing Address - Fax:
Practice Address - Street 1:113 LINCOLNWAY E
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46544-2016
Practice Address - Country:US
Practice Address - Phone:574-255-4976
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-19
Last Update Date:2008-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker