Provider Demographics
NPI:1992184246
Name:PALUMBO, MARIA CHRISTINA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:CHRISTINA
Last Name:PALUMBO
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 1:211 VILLAGE WALK
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-1238
Mailing Address - Country:US
Mailing Address - Phone:856-905-6150
Mailing Address - Fax:
Practice Address - Street 1:723 WHEATLAND ST
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-5361
Practice Address - Country:US
Practice Address - Phone:601-415-9301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-20
Last Update Date:2024-03-29
Deactivation Date:2017-02-28
Deactivation Code:
Reactivation Date:2024-03-29
Provider Licenses
StateLicense IDTaxonomies
PASW131073101YM0800X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health