Individual
JUAN A ORTIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC-1 C.A.S.
Contact information
Practice address
45 DIMOCK ST, ROXBURY, MA 02119-1208
(617) 442-8800
(617) 442-6268
Mailing address
55 DIMOCK ST, ROXBURY, MA 02119-1029
(617) 442-8800
(617) 442-4088
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1593
MA
Other
Enumeration date
11/01/2006
Last updated
03/11/2020
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