Individual
RAQUEL ANNA ORTIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
506 2ND ST, HAINESPORT, NJ 08036-2608
(609) 314-5237
Mailing address
506 2ND ST, HAINESPORT, NJ 08036-2608
(609) 314-5237
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/06/2020
Last updated
08/06/2020
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