Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 5478 | OH |
N | 103T00000X | Psychologist | 5478 | OH |
N | 102L00000X | Psychologist | PY7414 | FL |
N | 103T00000X | Psychologist | PY7414 | FL |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 5478 | OH |
N | 103TB0200X | Cognitive & Behavioral Psychologist | PY7414 | FL |
N | 103G00000X | Clinical Psychologist | 5478 | OH |
N | 103TC0700X | Clinical Psychologist | 5478 | OH |
Y | 103G00000X | Clinical Psychologist | PY7414 | FL |
Y | 103TC0700X | Clinical Psychologist | PY7414 | FL |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 5478 | OH |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | PY7414 | FL |
N | 103TF0200X | Forensic Psychologist | 5478 | OH |
N | 103TF0200X | Forensic Psychologist | PY7414 | FL |
N | 103TM1800X | Intellectual & Developmental Disabilities | 5478 | OH |
N | 103TM1800X | Intellectual & Developmental Disabilities | PY7414 | FL |
NPI | 1194777037 |
---|---|
Provider Name | Dr. David Allen Ott |
First Address | Oviedo, FL 32765-5105 |
Second Address | Orlando, FL 32803-8208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2006 |
Last Update Date | 12/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000347111 | ANTHEM (01) | OH |
2287047 | (05) | OH |
298511000 | MAGELLAN (01) | OH |