NPI | 1740489137 |
---|---|
Former Name | CARMEN J ORTIZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0701006505) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: DC PRC14584) |
Enumeration Date | 2007-07-16 |
Last Update Date | 2016-03-18 |