Basic Information
| Provider Information | |||||||||
| NPI: | 1730381997 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CORRIDORE | ||||||||
| FirstName: | MARIA | ||||||||
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| Credential: | MS, OTR/L, CLT, CHT | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2860 | ||||||||
| Address2: | |||||||||
| City: | ALAMOGORDO | ||||||||
| State: | NM | ||||||||
| PostalCode: | 883112860 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5754391397 | ||||||||
| FaxNumber: | 5754372622 | ||||||||
| Practice Location | |||||||||
| Address1: | 2351 INDIAN WELLS RD | ||||||||
| Address2: | |||||||||
| City: | ALAMOGORDO | ||||||||
| State: | NM | ||||||||
| PostalCode: | 883104607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5754391397 | ||||||||
| FaxNumber: | 5754372622 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2007 | ||||||||
| LastUpdateDate: | 08/23/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 3557 | NM | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.