Provider Demographics
NPI:1144488289
Name:ORTIZ, MICHELLE C (MA CCCSLP)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:C
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:MA CCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1445 BESSEMER DR STE C
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-5909
Mailing Address - Country:US
Mailing Address - Phone:915-633-1975
Mailing Address - Fax:855-533-1402
Practice Address - Street 1:1445 BESSEMER DR STE C
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-5909
Practice Address - Country:US
Practice Address - Phone:915-533-1400
Practice Address - Fax:855-533-1402
Is Sole Proprietor?:No
Enumeration Date:2008-05-27
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103209235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist