Provider Demographics
NPI:1811194848
Name:MAULHARDT-MEYRING, TIFFANY-BETH (OCCUPATIONAL THERAPI)
Entity Type:Individual
Prefix:
First Name:TIFFANY-BETH
Middle Name:
Last Name:MAULHARDT-MEYRING
Suffix:
Gender:F
Credentials:OCCUPATIONAL THERAPI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 GRANADA ST STE A
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-7725
Mailing Address - Country:US
Mailing Address - Phone:805-383-1501
Mailing Address - Fax:805-384-0748
Practice Address - Street 1:155 GRANADA ST STE A
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-7725
Practice Address - Country:US
Practice Address - Phone:805-383-1501
Practice Address - Fax:805-384-0748
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 3987225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist