Provider Demographics
NPI:1306392758
Name:ORTIGARA, ANNA (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:ORTIGARA
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8505 CROSS PARK DR
Mailing Address - Street 2:STE 120
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78754-4577
Mailing Address - Country:US
Mailing Address - Phone:512-615-6800
Mailing Address - Fax:512-615-7121
Practice Address - Street 1:8505 CROSS PARK DR
Practice Address - Street 2:STE 120
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78754-4577
Practice Address - Country:US
Practice Address - Phone:512-615-6800
Practice Address - Fax:512-615-7121
Is Sole Proprietor?:No
Enumeration Date:2016-08-26
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111355235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist