Individual
MR. JARED RYAN OSTERMILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
242 E 7TH N, STE 4, REXBURG, ID 83440-3550
(208) 359-9683
(208) 359-0889
Mailing address
242 E 7TH N, STE 4, REXBURG, ID 83440-3550
(208) 359-9683
(208) 359-9683
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-1351
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010146334
BLUE SHIELD
ID
05
—
806530400
—
ID
05
—
806867300
—
ID
01
—
L3688
BLUE CROSS
ID
Enumeration date
04/06/2007
Last updated
08/24/2018
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