Provider Demographics
NPI:1902348410
Name:ORTEGA, NATALIA (SLPA)
Entity Type:Individual
Prefix:
First Name:NATALIA
Middle Name:
Last Name:ORTEGA
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10313 W EARLL DR
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-4513
Mailing Address - Country:US
Mailing Address - Phone:602-380-5454
Mailing Address - Fax:
Practice Address - Street 1:11050 W WHYMAN AVE
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85323-9635
Practice Address - Country:US
Practice Address - Phone:623-478-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-15
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA76152355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant