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General NPI Number Information
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NPI Number | 1417323437
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Entity Type | Individual
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Provider Name | LAURA MALDONADO ALICEA MS, BCBA
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Gender | Female
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Dates
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Enumeration Date | 08/13/2015
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | C31 AVE APOLO ESQ RUFINO RODRIGUEZ
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City | GUAYNABO
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State | PR
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Zip | 00969
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Country | US
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Telephone | 787-221-0874
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Fax |
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Provider Business Mailing Address
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Address Line | 120 MAPLE ST
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City | SPRINGFIELD
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State | MA
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Zip | 01103-2203
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Country | US
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Telephone | 413-846-0445
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State | PR
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