Provider Demographics
NPI:1689454639
Name:SANTIAGO ORTIZ, KEISHLA MICHELLE (MSW)
Entity Type:Individual
Prefix:
First Name:KEISHLA
Middle Name:MICHELLE
Last Name:SANTIAGO ORTIZ
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 STOTLER RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15235-3807
Mailing Address - Country:US
Mailing Address - Phone:786-870-6697
Mailing Address - Fax:
Practice Address - Street 1:92 STOTLER RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15235-3807
Practice Address - Country:US
Practice Address - Phone:786-870-6697
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-05
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical