| Doctor Name: | MARIA MADRID |
| NPI Number: | 1063876308 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MFTI |
| License Number: | IMF82846 |
| Business Practice Address: | 81557 Dr Carreon Blvd Suite C-9 Indio, CA - 922015517 |
| Business Phone Number: | 7603916999 |
| Business Fax Number: | 7603916998 |
| Mailing Address: | 81557 Dr Carreon Blvd, Suite C-9 INDIO |
| State: | CA |
| Postal Code: | 922015517 |
| Phone Number: | 7603916999 |
| Fax Number: | 7603916998 |
| NPI Enumeration Date: | 04/13/2016 |
| NPI Last Update Date: | 04/13/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | IMF82846 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |