Provider Demographics
NPI:1316209422
Name:ORTIZ, LANA M
Entity Type:Individual
Prefix:
First Name:LANA
Middle Name:M
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3591 S KITTREDGE ST
Mailing Address - Street 2:#D
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80013-7201
Mailing Address - Country:US
Mailing Address - Phone:303-915-1645
Mailing Address - Fax:
Practice Address - Street 1:3591 S KITTREDGE ST
Practice Address - Street 2:D
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80013-7201
Practice Address - Country:US
Practice Address - Phone:303-915-1645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-13
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health