Individual
MRS. DIANE C. ORTIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LADAC
Contact information
Practice address
612 N PASEO DE ONATE, ESPANOLA, NM 87532-2963
(505) 753-2203
(505) 747-1881
Mailing address
PO BOX 520, 612 N. PASEO DE ONATE, ESPANOLA, NM 87532-0520
(505) 753-2203
(505) 747-1881
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0119851
NM
Other
Enumeration date
08/31/2009
Last updated
09/02/2009
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