Basic Information
| Provider Information | |||||||||
| NPI: | 1770864407 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ORTUNO | ||||||||
| FirstName: | KATHLEEN | ||||||||
| MiddleName: | DANIELLE | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LMHC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 717 PONCE DE LEON BLVD STE 307 | ||||||||
| Address2: | |||||||||
| City: | CORAL GABLES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331342070 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3054636690 | ||||||||
| FaxNumber: | 3054636693 | ||||||||
| Practice Location | |||||||||
| Address1: | 717 PONCE DE LEON BLVD STE 307 | ||||||||
| Address2: | |||||||||
| City: | CORAL GABLES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331342070 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3056193202 | ||||||||
| FaxNumber: | 3054636693 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/08/2011 | ||||||||
| LastUpdateDate: | 11/15/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | Y | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.