Provider Demographics
NPI:1912713066
Name:ORTIZ, DAYLEEN (MA)
Entity type:Individual
Prefix:
First Name:DAYLEEN
Middle Name:
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE MENDEZ VIGO W # 185
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680-6600
Mailing Address - Country:US
Mailing Address - Phone:787-659-3420
Mailing Address - Fax:
Practice Address - Street 1:CALLE MENDEZ VIGO W # 185
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-6600
Practice Address - Country:US
Practice Address - Phone:787-659-3420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-04
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
5841103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling