Individual
DOW GLENN OSTLUND II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, MS, LAC
Contact information
Practice address
4140 E BASELINE RD STE 101, MESA, AZ 85206-4413
(602) 837-5500
Mailing address
4140 E BASELINE RD STE 101, MESA, AZ 85206-4413
(812) 360-9092
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LAC-23492
AZ
Other
Enumeration date
05/08/2025
Last updated
05/08/2025
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