| Doctor Name: | JUAN LEONCIO ORTIZ |
| NPI Number: | 1295931970 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MS |
| License Number: | |
| Business Practice Address: | 125 South 5th St Pennsylvania Counseling Services Reading, PA - 19602 |
| Business Phone Number: | 6103205440 |
| Business Fax Number: | 6104322742 |
| Mailing Address: | 200 North 7th Street, Attn Managed Care LEBANON |
| State: | PA |
| Postal Code: | 17046 |
| Phone Number: | 7172731710 |
| Fax Number: | 7172731416 |
| NPI Enumeration Date: | 06/21/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |