Individual
IRENE CONSUELO ORTIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
1850 CAMERON GLEN DR, RESTON, VA 20190-3363
(703) 481-4238
Mailing address
1850 CAMERON GLEN DR, RESTON, VA 20190-3363
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
0001059220
VA
Other
Enumeration date
08/10/2006
Last updated
07/08/2007
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