Individual
LA-NIYAH ANGEL 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
27 OAK ST, BAY SHORE, NY 11706-7342
(631) 697-1530
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/29/2020
Last updated
11/29/2020
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