Provider Demographics
NPI:1922815489
Name:MALDONADO PABON, JOISEMARIE (MSW)
Entity type:Individual
Prefix:
First Name:JOISEMARIE
Middle Name:
Last Name:MALDONADO PABON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 91 BOX 10181
Mailing Address - Street 2:
Mailing Address - City:VEGA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00692-9653
Mailing Address - Country:US
Mailing Address - Phone:787-222-9809
Mailing Address - Fax:
Practice Address - Street 1:BO. CANDELARIA CARR. 647 KM. 6.3
Practice Address - Street 2:
Practice Address - City:VEGA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00692
Practice Address - Country:US
Practice Address - Phone:787-222-9809
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16984104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker