Provider Demographics
NPI:1629342035
Name:BALDRICH VALERIO, MARIA ALTAGRACIA (MED)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ALTAGRACIA
Last Name:BALDRICH VALERIO
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 WILSHIRE ST
Mailing Address - Street 2:
Mailing Address - City:WINTHROP
Mailing Address - State:MA
Mailing Address - Zip Code:02152-1909
Mailing Address - Country:US
Mailing Address - Phone:857-816-9760
Mailing Address - Fax:
Practice Address - Street 1:65 WILSHIRE ST
Practice Address - Street 2:
Practice Address - City:WINTHROP
Practice Address - State:MA
Practice Address - Zip Code:02152-1909
Practice Address - Country:US
Practice Address - Phone:857-816-9760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-02
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health