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General NPI Number Information
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NPI Number | 1083201768
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Entity Type | Organization
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Legal Business Name | MCADORY INC
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Dates
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Enumeration Date | 12/29/2020
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Last Update Date | 12/29/2020
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Provider Practice Location Address
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Address Line | 10737 LAUREL ST STE 102
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-3837
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Country | US
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Telephone | 760-552-5333
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Fax |
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Provider Business Mailing Address
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Address Line | 6858 CHARLOMA ST
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City | ALTA LOMA
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State | CA
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Zip | 91701-4868
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Country | US
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Telephone | 760-552-5333
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Fax |
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Authorized Official
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Title or Position | LICENSED MARRIAGE AND FAMILY
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Name | MISS EBONEE MCADORY
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Credential | LMFT
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Telephone | 760-552-5333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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