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1063854107
TINA M OVERSTREET
MOSCOW, ID
NPI
1063854107
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2013-07-17
Last Update Date
2022-04-15
Business Address
TINA M OVERSTREET SUDP
803 S MAIN ST STE 120
MOSCOW, ID 83843-2695
Phone number: 509-444-8200
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Mailing Address
TINA M OVERSTREET SUDP
611 N IRON BRIDGE WAY
SPOKANE, WA 99202-4932
Phone number: 509-444-8200
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