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General NPI Number Information
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NPI Number | 1396814554
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Entity Type | Individual
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Provider Name | DONNA MAE ORTEGA LPC
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Gender | Female
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3840 HULEN ST STE 602
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City | FORT WORTH
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State | TX
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Zip | 76107-7275
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Country | US
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Telephone | 817-683-0798
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Fax | 817-921-0273
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Provider Business Mailing Address
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Address Line | PO BOX 163498
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City | FORT WORTH
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State | TX
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Zip | 76161-3498
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Country | US
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Telephone | 817-683-0798
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Fax | 817-921-0273
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 19858
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License Number State | TX
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