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1538714795
GINA L OSTERLOTH
PAYETTE, ID
NPI
1538714795
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: ID 11675)
Enumeration Date
2019-08-05
Last Update Date
2019-08-05
Business Address
GINA L OSTERLOTH BA, CADC
540 S 16TH ST
PAYETTE, ID 83661-3513
Phone number: 208-297-8889
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Mailing Address
GINA L OSTERLOTH BA, CADC
540 S 16TH ST STE 118
PAYETTE, ID 83661-3514
Phone number: 208-297-8889
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