Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003404146 |
---|---|
Provider Name | Linda Michelle Maldonado |
First Address | Pasadena, CA 91106-2380 |
Second Address | Provo, UT 84601-5648 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2021 |
Last Update Date | 05/01/2021 |