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NPI 1215700992

NPI 1215700992 : JESSIFER ORTIZ : AIBONITO, PR

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General NPI Number Information
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    NPI Number           |    1215700992
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    Entity Type          |    Individual 
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    Provider Name        |    JESSIFER ORTIZ
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    11/03/2023
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    Last Update Date     |    11/03/2023
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Provider Practice Location Address
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    Address Line         |    CALLE SARGENTO GERARDO SANTIAGO CARRETERA 14 INTERIOR
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    City                 |    AIBONITO
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    State                |    PR
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    Zip                  |    00705
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    Country              |    US
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    Telephone            |    787-714-2462
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 371031 
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    City                 |    CAYEY
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    State                |    PR
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    Zip                  |    00737-1031
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    Country              |    US
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    Telephone            |    787-557-5958
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    16541
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    License Number State |    PR
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