Individual
MRS. KHRYSTA G ORTIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., BCBA, LBA
Contact information
Practice address
270 FARMINGTON AVE STE 264, FARMINGTON, CT 06032-1953
(860) 430-1762
Mailing address
229 HENRY ST, MANCHESTER, CT 06042-3243
(860) 670-8966
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-20-43250
CT
Other
Enumeration date
07/15/2020
Last updated
02/10/2025
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