Provider Demographics
NPI:1811609548
Name:MALDONADO, SUANIA (CLINICIAN)
Entity type:Individual
Prefix:
First Name:SUANIA
Middle Name:
Last Name:MALDONADO
Suffix:
Gender:F
Credentials:CLINICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 COUNTRYSIDE DR
Mailing Address - Street 2:
Mailing Address - City:PALMER
Mailing Address - State:MA
Mailing Address - Zip Code:01069-9693
Mailing Address - Country:US
Mailing Address - Phone:787-553-0617
Mailing Address - Fax:
Practice Address - Street 1:5 COUNTRYSIDE DR
Practice Address - Street 2:
Practice Address - City:PALMER
Practice Address - State:MA
Practice Address - Zip Code:01069-9693
Practice Address - Country:US
Practice Address - Phone:787-553-0617
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-13
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor