Provider Demographics
NPI:1730989344
Name:ORTEGA, TULIO ROBERTO (PSYD)
Entity type:Individual
Prefix:
First Name:TULIO
Middle Name:ROBERTO
Last Name:ORTEGA
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:239 GRANDVIEW AVE APT 102
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:KY
Mailing Address - Zip Code:41073-1575
Mailing Address - Country:US
Mailing Address - Phone:585-967-3306
Mailing Address - Fax:585-967-3306
Practice Address - Street 1:5100 N TOWNE CENTRE DR
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:MO
Practice Address - Zip Code:65721-7479
Practice Address - Country:US
Practice Address - Phone:417-730-5510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist