MEDICARE: MRS. MARY MARIA BALDON LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	56042	TX

General Provider Information

NPI Number	:	1326728650
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARY MARIA BALDON LCSW

Provider Business Mailing Address
First Line	:	8338 S MEADOW BIRD CIR
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77489-6148
Country	:	US
Telephone Number	:	832-279-0294
Fax Number	:

Provider Business Practice Location Address
First Line	:	8338 S MEADOW BIRD CIR
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77489-6148
Country	:	US
Telephone Number	:	832-279-0294
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2023
Last Update Date	:	07/21/2023

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