Provider Demographics
NPI:1457064149
Name:ORTIZ, TAIS ARLENE
Entity Type:Individual
Prefix:
First Name:TAIS
Middle Name:ARLENE
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URBANIZACION LOMAS VERDES CALLE EUCALIPTO
Mailing Address - Street 2:2D6
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956-3437
Mailing Address - Country:US
Mailing Address - Phone:787-590-8853
Mailing Address - Fax:
Practice Address - Street 1:URBANIZACION LOMAS VERDES CALLE EUCALIPTO
Practice Address - Street 2:2D6
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956-3437
Practice Address - Country:US
Practice Address - Phone:787-590-8853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-28
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR76132355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant