Provider Demographics
NPI:1275847915
Name:ORTEGA, AISHAH YAASMEEN (PHD, CCC-SLP)
Entity Type:Individual
Prefix:DR
First Name:AISHAH
Middle Name:YAASMEEN
Last Name:ORTEGA
Suffix:
Gender:F
Credentials:PHD, CCC-SLP
Other - Prefix:
Other - First Name:AISHAH
Other - Middle Name:YAASMEEN
Other - Last Name:PATTERSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 30001/MSC 3SPE
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88003-8001
Mailing Address - Country:US
Mailing Address - Phone:575-646-7687
Mailing Address - Fax:575-646-7712
Practice Address - Street 1:1405 INTERNATIONAL MALL
Practice Address - Street 2:SPEECH BLDG. ROOM 158
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88003-1279
Practice Address - Country:US
Practice Address - Phone:575-646-7687
Practice Address - Fax:575-646-7712
Is Sole Proprietor?:No
Enumeration Date:2010-08-05
Last Update Date:2010-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM4694235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist