Provider Demographics
NPI:1639498710
Name:VALDOVINOS, MARIA (BCBA-D)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:VALDOVINOS
Suffix:
Gender:F
Credentials:BCBA-D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5405 HARWOOD DR
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50312-1842
Mailing Address - Country:US
Mailing Address - Phone:515-418-3393
Mailing Address - Fax:515-271-1925
Practice Address - Street 1:5405 HARWOOD DR
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50312-1842
Practice Address - Country:US
Practice Address - Phone:515-418-3393
Practice Address - Fax:515-271-1925
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-27
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-03-1451103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst