Provider Demographics
NPI:1619044641
Name:MALDONADO-SAAD, JANELLE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JANELLE
Middle Name:
Last Name:MALDONADO-SAAD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:JANELLE
Other - Middle Name:ANNETTE
Other - Last Name:MALDONADO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:12812 BOXWOOD COURT
Mailing Address - Street 2:
Mailing Address - City:UNION BRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21791-7508
Mailing Address - Country:US
Mailing Address - Phone:301-898-1160
Mailing Address - Fax:301-898-0888
Practice Address - Street 1:12812 BOXWOOD LN
Practice Address - Street 2:
Practice Address - City:UNION BRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21791-7508
Practice Address - Country:US
Practice Address - Phone:301-898-1160
Practice Address - Fax:301-898-0888
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02533103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD52447503OtherBCBS
MD680008161Medicare ID - Type UnspecifiedTRAILBLAZER PALMETTO
MD52447503OtherBCBS