Individual
JESSICA LEIGH ORTIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
TLLP
Contact information
Practice address
26105 ORCHARD LAKE RD STE 207, FARMINGTON HILLS, MI 48334-4578
(248) 662-5437
Mailing address
18995 WHITBY ST, LIVONIA, MI 48152-3035
(616) 566-8250
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6362002993
MI
Other
Enumeration date
08/29/2019
Last updated
04/27/2020
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