Provider Demographics
NPI:1457558678
Name:MARTIN, AMPARO ORTIZ (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:AMPARO
Middle Name:ORTIZ
Last Name:MARTIN
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 1:3251 N PLACITA DE CORONADO
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85749-8860
Mailing Address - Country:US
Mailing Address - Phone:520-760-1876
Mailing Address - Fax:
Practice Address - Street 1:BENSON HOSPITAL
Practice Address - Street 2:450 S. OCOTILLO RD.
Practice Address - City:BENSON
Practice Address - State:AZ
Practice Address - Zip Code:85602
Practice Address - Country:US
Practice Address - Phone:877-236-4677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP1122235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist