Doctor Name: | JESSICA NICOLE CORTEZ |
NPI Number: | 1144524984 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMSW |
License Number: | |
Business Practice Address: | 1086 Orndorf Dr Brighton, MI - 481162308 |
Business Phone Number: | 5172560896 |
Business Fax Number: | 5176553738 |
Mailing Address: | 1851 Rosemont Rd, BERKLEY |
State: | MI |
Postal Code: | 480721845 |
Phone Number: | 5172560896 |
Fax Number: | 5176553738 |
NPI Enumeration Date: | 01/10/2011 |
NPI Last Update Date: | 02/06/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MI |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |