Sandra Ortiz, ICADC
Counselor, Addiction (Substance Use Disorder) in Fort Hall, ID. Individual provider (NPI-1).
NPI number1396909024
StatusActive
Last updated in NPPESJul 11, 2008
Details
- NPI
- 1396909024
- Entity type
- Individual (NPI-1)
- Name
- Sandra Ortiz
- Credential
- ICADC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 11, 2008
- Last updated
- Jul 11, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | ICADC 22075 | ID | Yes |
Practice location
115 Pima DriveFort Hall, ID 83203-0306
Phone 208-238-2400 · Fax 208-238-5462
Mailing address
East Agency RdFort Hall, ID 83203
Phone 208-238-2400 · Fax 208-238-5462
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