Provider Demographics
NPI:1184909178
Name:HALDEMAN, MARIA THERESE
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:THERESE
Last Name:HALDEMAN
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:PO BOX 382
Mailing Address - Street 2:
Mailing Address - City:MERION STATION
Mailing Address - State:PA
Mailing Address - Zip Code:19066-0382
Mailing Address - Country:US
Mailing Address - Phone:215-450-1538
Mailing Address - Fax:
Practice Address - Street 1:150 E WYNNEWOOD RD
Practice Address - Street 2:APT 20F
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-1547
Practice Address - Country:US
Practice Address - Phone:215-450-1538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-21
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist