Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YS0200X | School Counselor | WA |
NPI | 1013192491 |
---|---|
Provider Name | Gabriel Ortiz |
First Address | San Antonio, TX 78255-1142 |
Second Address | San Antonio, TX 78255-1142 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2008 |
Last Update Date | 25/02/2008 |