Individual
TANISTTA LASHAWN ORTIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
225 BROADHOLLOW RD STE 402, MELVILLE, NY 11747-4899
(631) 385-7780
Mailing address
56 IRVING AVE, WYANDANCH, NY 11798-3421
(934) 204-8741
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
NY
Other
Enumeration date
03/05/2024
Last updated
03/05/2024
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