Provider Demographics
NPI:1609217538
Name:MALDONADO, JESSICA
Entity Type:Individual
Prefix:MISS
First Name:JESSICA
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 1:1931 NOTTINGHAM WAY
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-3554
Mailing Address - Country:US
Mailing Address - Phone:609-882-1898
Mailing Address - Fax:609-882-3880
Practice Address - Street 1:1925 PENNINGTON RD
Practice Address - Street 2:
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08618-1105
Practice Address - Country:US
Practice Address - Phone:609-882-1898
Practice Address - Fax:609-882-3880
Is Sole Proprietor?:No
Enumeration Date:2013-07-08
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor