Individual
MRS. MIRIAM M ORTIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LBSW
Contact information
Practice address
11 BREAKERS PT, SAN ANTONIO, TX 78238-1336
(210) 724-2639
Mailing address
11 BREAKERS PT, SAN ANTONIO, TX 78238-1336
(210) 724-2639
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
29071
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
172459301
—
TX
Enumeration date
10/31/2006
Last updated
12/05/2012
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