Provider Demographics
NPI:1922432186
Name:MALDONADO, PATRICIA A
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:A
Last Name:MALDONADO
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:PATRICA
Other - Middle Name:A
Other - Last Name:GALLETTA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:632 PRIMROSE LN
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-4679
Mailing Address - Country:US
Mailing Address - Phone:610-849-2291
Mailing Address - Fax:610-419-3046
Practice Address - Street 1:632 PRIMROSE LN
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-4679
Practice Address - Country:US
Practice Address - Phone:610-849-2291
Practice Address - Fax:610-419-3046
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-23
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW129769104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker