Provider Demographics
NPI:1689722928
Name:OSTERLOH, RUBY K (MA, CCC-A)
Entity Type:Individual
Prefix:MRS
First Name:RUBY
Middle Name:K
Last Name:OSTERLOH
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:MS
Other - First Name:RUBY
Other - Middle Name:K
Other - Last Name:MIERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:2900 4TH AVE N
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-1266
Mailing Address - Country:US
Mailing Address - Phone:406-247-7112
Mailing Address - Fax:
Practice Address - Street 1:2900 4TH AVE N
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-1266
Practice Address - Country:US
Practice Address - Phone:406-247-7112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE187231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA3583732Medicaid
IA9583724Medicaid
IA1583724Medicaid
IA6583724Medicaid
IA4583724Medicaid
IA5583724Medicaid
MT1689722928OtherINDIAN HEALTH SERVICE, CONTRACT AUDIOLOGIST
IA2583724Medicaid
IA2583732Medicaid
NE36832OtherBCBS ENT
NE36835OtherBCBS BT
IA8583724Medicaid
IA0583724Medicaid
IA3583724Medicaid
IA0583732Medicaid
IA7583724Medicaid
IA1583732Medicaid
IA1583732Medicaid
IA7583724Medicaid