Individual
MR. CHARLIE ORTIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
760 PROSPECT AVE, HARTFORD, CT 06105-4221
(860) 841-2345
Mailing address
760 PROSPECT AVE, HARTFORD, CT 06105-4221
(860) 841-2345
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
001004
CT
Other
Enumeration date
03/09/2016
Last updated
03/09/2016
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