Provider Demographics
NPI:1659833101
Name:MASCARENAS, MARIA L
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:L
Last Name:MASCARENAS
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 1:232 ARMIJO RD
Mailing Address - Street 2:
Mailing Address - City:BELEN
Mailing Address - State:NM
Mailing Address - Zip Code:87002-7273
Mailing Address - Country:US
Mailing Address - Phone:505-712-7617
Mailing Address - Fax:
Practice Address - Street 1:232 ARMIJO RD
Practice Address - Street 2:
Practice Address - City:BELEN
Practice Address - State:NM
Practice Address - Zip Code:87002-7273
Practice Address - Country:US
Practice Address - Phone:505-712-7617
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-03
Last Update Date:2019-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician