| NPI | 1821630641 |
|---|---|
| Former Name | JESSICA ORTIZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246Z00000X Specialist/Technologist, Other |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| 174400000X Specialist | |
| Enumeration Date | 2019-10-14 |
| Last Update Date | 2024-03-12 |