person
Gary Dale Conder, ICADC
Addiction (Substance Use Disorder) Counselor in Fort Hall, Idaho
NPI 1538323225

Gary Dale Conder is an Addiction (Substance Use Disorder) Counselor based in Fort Hall, ID and is specialized in Addiction (Substance Use Disorder). Gary Dale Conder practices in Fort Hall, ID and has the professional credentials of ICADC. The NPI Number for Gary Dale Conder is 1538323225 and holds a License No. DA116101G (Idaho).

The current practice location address for Gary Dale Conder is 115 Pima Drive, Fort Hall, ID and can be reached out via phone at 208-238-2400 and via fax at 208-238-5462.

Location: 115 Pima Drive, Fort Hall, ID, 83203-0306
person
Provider Profile Details
NPI Number
1538323225
Provider Name
Gary Dale Conder
Credential
ICADC
Provider Entity Type
Individual
Gender
Male
Address
115 Pima Drive, Fort Hall, ID, 83203-0306
Phone Number
208-238-2400
Fax Number
208-238-5462
Provider Enumeration Date
07/11/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
003399100 05 ID
institution
Provider Business Practice Location Address Details
Address
115 Pima Drive
City
State
Zip
83203-0306
Phone Number
208-238-2400
Fax Number
208-238-5462
person
Provider Business Mailing Address Details
Address
115 Pima Drive
City
State
Zip
83203-0306
Phone Number
208-238-2400
Fax Number
208-238-5462
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
DA116101G (Idaho)
Definition
Definition to come...
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