Individual
TODD OSTERTAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
7766 HIGHWAY 65 NE, SPRING LAKE PARK, MN 55432-2868
(763) 789-4895
(763) 789-4798
Mailing address
7766 HIGHWAY 65 NE, SPRING LAKE PARK, MN 55432-2868
(763) 789-4895
(763) 789-4798
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
303780
MN
Other
Enumeration date
12/06/2018
Last updated
12/06/2018
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