Individual
ILEANA MALDONADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
79 BEACON ST, WATERBURY, CT 06704-3424
(203) 574-3311
Mailing address
189 LINCOLNDALE DR, WATERBURY, CT 06704-1162
(203) 519-4638
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/15/2017
Last updated
11/15/2017
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