Individual
TANYA ORTIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICENSED DIETITIAN
Contact information
Practice address
2200 LEMP, ST. LOUIS, MO 63104
(314) 814-8556
(314) 814-8542
Mailing address
2220 LEMP AVE, SAINT LOUIS, MO 63104-2700
(314) 814-8556
(314) 814-8542
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
2004008861
MO
Other
Enumeration date
05/08/2009
Last updated
05/08/2009
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