Individual
DIANE OSTLUND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3450 N 3RD ST, PHOENIX, AZ 85012-2331
(602) 257-9339
(602) 265-8533
Mailing address
1424 S 7TH AVE BLDG C, PHOENIX, AZ 85007-3902
(602) 258-3600
(602) 256-0514
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13364
AZ
Other
Enumeration date
06/03/2015
Last updated
06/03/2015
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