Provider Demographics
NPI:1730319245
Name:MALDONADO, MARISOL (MSW)
Entity Type:Individual
Prefix:MRS
First Name:MARISOL
Middle Name:
Last Name:MALDONADO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 362
Mailing Address - Street 2:
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00986-0362
Mailing Address - Country:US
Mailing Address - Phone:787-344-7145
Mailing Address - Fax:
Practice Address - Street 1:8 STREET
Practice Address - Street 2:# 80
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00978
Practice Address - Country:US
Practice Address - Phone:787-344-7145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-17
Last Update Date:2009-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR154001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical