Healthcare Provider Details

I. General information

NPI: 1386554350
Provider Name (Legal Business Name): ANA ESPINO ORTIZ MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 OAK RIDGE DR
EAU CLAIRE WI
54701-6133
US

IV. Provider business mailing address

619 FULTON ST APT 1
EAU CLAIRE WI
54703-5392
US

V. Phone/Fax

Practice location:
  • Phone: 715-246-4840
  • Fax:
Mailing address:
  • Phone: 715-255-3164
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number9268-226
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: