Individual
MARK ANTHONY MALDONADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1558 HAYES DR, MANHATTAN, KS 66502-5068
(785) 587-4300
(785) 587-4315
Mailing address
2001 CLAFLIN RD, MANHATTAN, KS 66502-3415
(785) 587-4300
(785) 587-4363
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1550
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1009803A
—
KS
Enumeration date
11/07/2017
Last updated
11/07/2017
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