Individual
AYANNA ORTIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16 BANGOR ST, WORCESTER, MA 01604
(508) 363-0200
Mailing address
16 BANGOR ST, WORCESTER, MA 01604
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
S09962408
MA
Other
Enumeration date
01/22/2015
Last updated
01/22/2015
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