Provider Demographics
NPI:1831689553
Name:GUEDES-ORTEGA, KENIA
Entity type:Individual
Prefix:
First Name:KENIA
Middle Name:
Last Name:GUEDES-ORTEGA
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 1:35 GRAMMONT RD APT 2
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01607-1175
Mailing Address - Country:US
Mailing Address - Phone:508-667-2782
Mailing Address - Fax:
Practice Address - Street 1:35 GRAMMONT RD APT 2
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01607-1175
Practice Address - Country:US
Practice Address - Phone:508-667-2782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-17
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program