Healthcare Provider Details

I. General information

NPI: 1619044641
Provider Name (Legal Business Name): JANELLE MALDONADO-SAAD PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JANELLE ANNETTE MALDONADO PH.D.

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 02/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12812 BOXWOOD LN
UNION BRIDGE MD
21791-7508
US

IV. Provider business mailing address

12812 BOXWOOD COURT
UNION BRIDGE MD
21791-7508
US

V. Phone/Fax

Practice location:
  • Phone: 301-898-1160
  • Fax: 301-898-0888
Mailing address:
  • Phone: 301-898-1160
  • Fax: 301-898-0888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number02533
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: