Healthcare Provider Details

I. General information

NPI: 1073027470
Provider Name (Legal Business Name): DANIELLE ORTIZ M.S., SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2017
Last Update Date: 09/11/2025
Certification Date: 02/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 NOTTINGHAM PL W
SAN ANTONIO TX
78209-1887
US

IV. Provider business mailing address

6723 FREEDOM RDG
SAN ANTONIO TX
78242-2016
US

V. Phone/Fax

Practice location:
  • Phone: 210-824-2314
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number1575
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: