Individual
GLORIA L ORTIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
203 N AVENUE C, CRYSTAL CITY, TX 78839-3550
(830) 374-9191
Mailing address
203 N AVENUE C, CRYSTAL CITY, TX 78839-3550
(830) 374-9191
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
20004
TX
101YP2500X
Professional Counselor
20004
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
177998501
—
TX
01
—
84860L
BLUE CROSS BLUE SHIELD
TX
Enumeration date
04/03/2006
Last updated
02/01/2024
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