| Sandra Ortiz, ICADC | |
|
115 Pima Drive, Fort Hall, ID 83203-0306 | |
| (208) 238-2400 | |
| (208) 238-5462 |
| Full Name | Sandra Ortiz |
|---|---|
| Gender | Female |
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 115 Pima Drive, Fort Hall, Idaho |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396909024 | NPI | - | NPPES |
| 003399100 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | ICADC 22075 (Idaho) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Sandra Ortiz, ICADC East Agency Rd, Fort Hall, ID 83203 Ph: (208) 238-2400 | Sandra Ortiz, ICADC 115 Pima Drive, Fort Hall, ID 83203-0306 Ph: (208) 238-2400 |
Gary Dale Conder, ICADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 115 Pima Drive, Fort Hall, ID 83203 Phone: 208-238-2400 Fax: 208-238-5462 | |
Ms. Scotti L Brownley, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: Mission Road Bldg 248, Fort Hall Indian Agency, Fort Hall, ID 83203 Phone: 208-237-5631 Fax: 208-237-5796 | |
Nava Reneda, CADC Counselor Medicare: Not Enrolled in Medicare Practice Location: East Agency Rd, Fort Hall, ID 83203 Phone: 208-238-2400 Fax: 208-238-5462 |