Individual
YANEISHKA ODRACIR ORTIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
640 BROAD ST, PROVIDENCE, RI 02907-1463
(401) 390-6816
Mailing address
2597 HARTFORD AVE, JOHNSTON, RI 02919-1620
(347) 935-2856
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
202018
RI
Other
Enumeration date
07/11/2025
Last updated
07/11/2025
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