Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor |
NPI | 1205097177 |
---|---|
Provider Name | Connie Ortiz |
First Address | Brooklyn, NY 11215-5004 |
Second Address | Brooklyn, NY 11215-5004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2008 |
Last Update Date | 25/06/2008 |