Individual
MS. ELYSE NICHOLE ORTEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
7211 REGENCY SQUARE BLVD, HOUSTON, TX 77036-3138
(713) 244-9505
Mailing address
12055 SABO RD APT 627, HOUSTON, TX 77089-6288
(832) 771-8310
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
214872
TX
Other
Enumeration date
03/08/2018
Last updated
03/08/2018
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