Provider Demographics
NPI:1316422959
Name:ORDUNA, ITZEL (PHD)
Entity type:Individual
Prefix:DR
First Name:ITZEL
Middle Name:
Last Name:ORDUNA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4360 GUNNVILLE RD
Mailing Address - Street 2:
Mailing Address - City:CLARENCE
Mailing Address - State:NY
Mailing Address - Zip Code:14031-1939
Mailing Address - Country:US
Mailing Address - Phone:716-348-8260
Mailing Address - Fax:
Practice Address - Street 1:9880 TRANSIT RD STE A
Practice Address - Street 2:
Practice Address - City:EAST AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14051-5200
Practice Address - Country:US
Practice Address - Phone:716-276-9520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-29
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023529103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling