Individual
MR. JUAN CARLOS ORTEGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 CUMMINGS CTR, SUITE 360 U, BEVERLY, MA 01915-6175
(978) 201-1066
Mailing address
800 CUMMINGS CTR, SUITE 360 U, BEVERLY, MA 01915-6175
(978) 201-1066
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
450953
MN
Other
Enumeration date
11/15/2012
Last updated
11/15/2012
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