Provider Demographics
NPI:1508579251
Name:ORTIZ, CRISTINA (THL)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:THL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SIERRA BAYAMON BLOQUE 25 B CALLE 25 A #12
Mailing Address - Street 2:CALLE 25A BLOQUE 25B #12
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00961
Mailing Address - Country:US
Mailing Address - Phone:939-577-4316
Mailing Address - Fax:
Practice Address - Street 1:SIERRA BAYAMON BLOQUE 25 B CALLE 25 A #12
Practice Address - Street 2:CALLE 25A BLOQUE 25B #12
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961
Practice Address - Country:US
Practice Address - Phone:939-577-4316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-27
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR75522355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant