Most Relevant Information
Provider Data
| NPI Number: | 1003525601 |
| Provider Name: | ROOSEVELT MALDONADO |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | CSW02822 |
Most Important Dates
| Enumeration Date: | 11/22/2022 |
| Last Updated: | 11/22/2022 |
Provider Practice Location
830 CHALKSTONE AVE
PROVIDENCE
RI
029084734
Practice Location Phone/Fax
| Phone: | 4012737100 |
| Fax: |
Provider Mailing Location
830 CHALKSTONE AVE
PROVIDENCE
RI
029084734
Provider Mailing Phone/Fax
| Phone: | 4012737100 |
| Fax: |