Healthcare Provider Details

I. General information

NPI: 1013830975
Provider Name (Legal Business Name): MARIA OLIVIA PACLEB LP-CAT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

134 E 177TH ST
BRONX NY
10453-5902
US

IV. Provider business mailing address

134 E 177TH ST
BRONX NY
10453-5902
US

V. Phone/Fax

Practice location:
  • Phone: 212-665-1860
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code221700000X
TaxonomyArt Therapist
License NumberP144340
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: