Provider Demographics
NPI:1134532518
Name:ORTIZ, JANIE (MS CCC- SLP)
Entity type:Individual
Prefix:
First Name:JANIE
Middle Name:
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:MS CCC- SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 MOSSYCUP DR
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-2891
Mailing Address - Country:US
Mailing Address - Phone:956-929-8092
Mailing Address - Fax:
Practice Address - Street 1:222 MOSSYCUP DR
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-2891
Practice Address - Country:US
Practice Address - Phone:956-929-8092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-03
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX116821235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist