Individual
MISS SHAWNE STACIE ORTIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD, LPC-S
Contact information
Practice address
2556 HUNT ST, NEW BRAUNFELS, TX 78130-2998
(210) 685-1529
(866) 556-8569
Mailing address
2556 HUNT ST, NEW BRAUNFELS, TX 78130-2998
(210) 685-1529
(866) 556-8569
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
61423
TX
101YP2500X
Professional Counselor
61423
TX
103TC1900X
Counseling Psychologist
Primary
36936
TX
103TM1800X
Intellectual & Developmental Disabilities Psychologist
34976
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
179138601
—
TX
05
—
179138602
—
TX
Enumeration date
05/23/2007
Last updated
08/04/2021
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