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General NPI Number Information
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NPI Number | 1194237461
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Entity Type | Individual
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Provider Name | DOLORES MARIA CORTES MELDRUM OTR/L
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Gender | Female
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Dates
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Enumeration Date | 10/26/2017
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Last Update Date | 10/26/2017
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Provider Practice Location Address
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Address Line | 3602 INLAND EMPIRE BLVD STE B208
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City | ONTARIO
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State | CA
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Zip | 91764-4912
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Country | US
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Telephone | 909-476-6464
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Fax | 909-476-6868
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Provider Business Mailing Address
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Address Line | 2214 N LAUREL WAY
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City | UPLAND
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State | CA
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Zip | 91784-1344
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Country | US
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Telephone | 857-928-5022
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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