Healthcare Provider Details

I. General information

NPI: 1255266987
Provider Name (Legal Business Name): MARIA ALTHEA VALENCIA GUIAO
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3407 LABYRINTH RD
BALTIMORE MD
21215-1714
US

IV. Provider business mailing address

338 WHITESVILLE RD
JACKSON NJ
08527-5037
US

V. Phone/Fax

Practice location:
  • Phone: 732-380-5222
  • Fax:
Mailing address:
  • Phone: 732-380-5222
  • Fax: 732-380-5222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: