| Doctor Name: | MISS MARISOL MALDONADO |
| NPI Number: | 1447412010 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | RI-M0801291523 |
| Business Practice Address: | 11600 Eldridge Ave Lake View Terrace, CA - 913426506 |
| Business Phone Number: | 8186863190 |
| Business Fax Number: | |
| Mailing Address: | 11600 Eldridge Ave, LAKE VIEW TERRACE |
| State: | CA |
| Postal Code: | 913426506 |
| Phone Number: | 8186263190 |
| Fax Number: | |
| NPI Enumeration Date: | 06/25/2008 |
| NPI Last Update Date: | 06/25/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | RI-M0801291523 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |