Provider Demographics
NPI:1225754948
Name:CORTEZ, LETISHA (MS,GC)
Entity type:Individual
Prefix:
First Name:LETISHA
Middle Name:
Last Name:CORTEZ
Suffix:
Gender:F
Credentials:MS,GC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6350 CENTER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-4107
Mailing Address - Country:US
Mailing Address - Phone:579-055-5587
Mailing Address - Fax:757-213-5762
Practice Address - Street 1:744 BATTLEFIELD BLVD N STE 200
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-4941
Practice Address - Country:US
Practice Address - Phone:757-549-4403
Practice Address - Fax:757-549-4332
Is Sole Proprietor?:No
Enumeration Date:2022-10-14
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0139000778170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS