MEDICARE: CHRISTINA ORTIZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1891046322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA ORTIZ

Provider Business Mailing Address
First Line	:	8812 N KENSINGTON RD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73132-2630
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8812 N KENSINGTON RD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73132-2630
Country	:	US
Telephone Number	:	917-586-2079
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2012
Last Update Date	:	09/24/2012

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Directions to “ CHRISTINA ORTIZ ” Practice Location

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