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General NPI Number Information
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NPI Number | 1750907358
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Entity Type | Individual
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Provider Name | MISS KIARA ORTIZ
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Gender | Female
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Dates
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Enumeration Date | 06/19/2020
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Last Update Date | 05/25/2022
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Provider Practice Location Address
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Address Line | 417 LIBERTY ST
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City | SPRINGFIELD
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State | MA
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Zip | 01104-3736
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Country | US
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Telephone | 413-733-6661
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Fax |
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Provider Business Mailing Address
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Address Line | 11 SEVER ST APT 308
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City | WORCESTER
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State | MA
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Zip | 01609-2130
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Country | US
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Telephone | 508-579-3927
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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 | 227170
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License Number State | MA
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