Individual
AMANDA ANN ORTIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
1218 79TH ST, KENOSHA, WI 53143-6111
(262) 658-9500
(262) 764-0751
Mailing address
1218 79TH ST, KENOSHA, WI 53143-6111
(262) 658-9500
(262) 764-0751
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5548-26
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100052780
—
WI
Enumeration date
04/06/2015
Last updated
11/14/2025
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