Provider Demographics
NPI:1518251289
Name:ORTIZ-THOW, TANYA RAE (OTR/L)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:RAE
Last Name:ORTIZ-THOW
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1054 GOLDEN SPLENDOR CT
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89002-9800
Mailing Address - Country:US
Mailing Address - Phone:702-568-8782
Mailing Address - Fax:702-568-8782
Practice Address - Street 1:2075 E FLAMINGO RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5188
Practice Address - Country:US
Practice Address - Phone:702-568-8782
Practice Address - Fax:702-568-8782
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-30
Last Update Date:2011-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0525225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist