Provider Demographics
NPI:1679820864
Name:ORTIZ-DEL FIERRO, SANDRA (LPC)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:ORTIZ-DEL FIERRO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 N TEXAS BLVD
Mailing Address - Street 2:
Mailing Address - City:ALICE
Mailing Address - State:TX
Mailing Address - Zip Code:78332-5039
Mailing Address - Country:US
Mailing Address - Phone:361-396-0499
Mailing Address - Fax:361-668-3033
Practice Address - Street 1:408 N TEXAS BLVD
Practice Address - Street 2:
Practice Address - City:ALICE
Practice Address - State:TX
Practice Address - Zip Code:78332-5039
Practice Address - Country:US
Practice Address - Phone:361-396-0499
Practice Address - Fax:361-668-3033
Is Sole Proprietor?:No
Enumeration Date:2012-08-07
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66317101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional