Provider Demographics
NPI:1891531422
Name:ORELLANA, MECSELDER ADOLFO
Entity type:Individual
Prefix:
First Name:MECSELDER
Middle Name:ADOLFO
Last Name:ORELLANA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 CHARLESTON PL
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20783-2860
Mailing Address - Country:US
Mailing Address - Phone:240-501-0476
Mailing Address - Fax:
Practice Address - Street 1:11720 BELTSVILLE DR STE 500-A15
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-3166
Practice Address - Country:US
Practice Address - Phone:202-960-6199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-03
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician