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General NPI Number Information
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NPI Number | 1629798301
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Entity Type | Individual
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Provider Name | WAILANI ORTIZ ORTIZ
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Gender | Female
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Dates
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Enumeration Date | 09/01/2022
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Last Update Date | 10/24/2022
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Provider Practice Location Address
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Address Line | CARR 117 KM 1.1 INT BO. SANTA ROSA
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City | LAJAS
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State | PR
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Zip | 00667
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Country | US
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Telephone | 787-619-7916
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Fax |
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Provider Business Mailing Address
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Address Line | HC 1 BOX 5641
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City | SAN GERMAN
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State | PR
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Zip | 00683-9609
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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