Individual
MRS. MARILYN MALDONADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4915 DONOVAN AVE, SAINT LOUIS, MO 63109-2631
(314) 481-4095
Mailing address
11960 WESTLINE INDUSTRIAL DR STE 201, SAINT LOUIS, MO 63146-3209
(866) 433-9555
(314) 275-7444
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000076011
ESSENCE HEALTHCARE
MO
Enumeration date
03/04/2015
Last updated
03/04/2015
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