Provider Demographics
NPI:1083301774
Name:DALTON, MELISSA (CNMT)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:
Last Name:DALTON
Suffix:
Gender:F
Credentials:CNMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18351 BEACH BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-1346
Mailing Address - Country:US
Mailing Address - Phone:714-913-3310
Mailing Address - Fax:
Practice Address - Street 1:18351 BEACH BLVD STE B
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-1346
Practice Address - Country:US
Practice Address - Phone:714-913-3310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-21
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA71812225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist