Provider Demographics
NPI:1861167405
Name:ORTIZ, MARGARET LOVE (LCDCIII)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:LOVE
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:LCDCIII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8540 TIMBER PARK DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45458-2035
Mailing Address - Country:US
Mailing Address - Phone:937-272-7745
Mailing Address - Fax:
Practice Address - Street 1:8540 TIMBER PARK DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45458-2035
Practice Address - Country:US
Practice Address - Phone:937-272-7745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH161851101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)