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NPI 1225712680

NPI 1225712680 : EMELY Y FORTIZ : WASHINGTON, DC

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General NPI Number Information
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    NPI Number           |    1225712680
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    Entity Type          |    Individual 
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    Provider Name        |    EMELY Y FORTIZ
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    06/14/2023
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    Last Update Date     |    04/11/2025
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Provider Practice Location Address
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    Address Line         |    915 RHODE ISLAND AVE NW 
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    City                 |    WASHINGTON
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    State                |    DC
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    Zip                  |    20001-4153
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    Country              |    US
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    Telephone            |    202-232-6100
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    Fax                  |    202-644-7024
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Provider Business Mailing Address
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    Address Line         |    1001 LAWRENCE ST NE 
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    City                 |    WASHINGTON
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    State                |    DC
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    Zip                  |    20017-3513
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    Country              |    US
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    Telephone            |    
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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        |    104100000X
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    Taxonomy Name        |    Social Worker
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    License Number       |    LG200002861
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    License Number State |    DC
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