Individual
CHARLYNE ORTIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11 TREMONT ST, LAWRENCE, MA 01841-3634
(978) 902-4173
Mailing address
11 TREMONT ST, LAWRENCE, MA 01841-3634
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S77096604
LICENSE
MA
Enumeration date
07/10/2018
Last updated
07/10/2018
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