Individual
DORALIZ ORTIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
HC 1 BOX 12050, HATILLO, PR 00659-7404
(787) 368-4525
Mailing address
HC 1 BOX 12050, HATILLO, PR 00659-7404
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
5700
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2306528
LICENCE NUMBER
PR
Enumeration date
09/21/2017
Last updated
09/21/2017
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