Individual
ALLIE J CORTEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
1525 N RITTER AVE, INDIANAPOLIS, IN 46219-3026
(317) 621-7561
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
99091237A
IN
1041C0700X
Clinical Social Worker
Primary
34009401A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200238820
—
IN
Enumeration date
03/19/2019
Last updated
08/24/2021
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