Provider Demographics
NPI:1639769664
Name:GALDEANO, ANALIESE MARIE
Entity Type:Individual
Prefix:
First Name:ANALIESE
Middle Name:MARIE
Last Name:GALDEANO
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 1:744 FAWCETT AVE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98402-5505
Mailing Address - Country:US
Mailing Address - Phone:210-259-7909
Mailing Address - Fax:
Practice Address - Street 1:744 FAWCETT AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-5505
Practice Address - Country:US
Practice Address - Phone:210-259-7909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-23
Last Update Date:2021-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician