Individual
MAYRA MALDONADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
501 LOMBARD ST, NEW HAVEN, CT 06513-2910
(203) 787-2207
Mailing address
477 BEAVER ST APT G2, ANSONIA, CT 06401-2053
(203) 981-0627
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004235918
—
CT
Enumeration date
05/22/2007
Last updated
10/30/2013
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