Provider Demographics
NPI:1053082859
Name:ORDAZ, OSIRIS ARLET (MA)
Entity Type:Individual
Prefix:
First Name:OSIRIS
Middle Name:ARLET
Last Name:ORDAZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2172 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SIOUX CENTER
Mailing Address - State:IA
Mailing Address - Zip Code:51250-2932
Mailing Address - Country:US
Mailing Address - Phone:708-374-1525
Mailing Address - Fax:
Practice Address - Street 1:33 4TH ST NW
Practice Address - Street 2:
Practice Address - City:SIOUX CENTER
Practice Address - State:IA
Practice Address - Zip Code:51250-1870
Practice Address - Country:US
Practice Address - Phone:712-722-1700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-22
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health