Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist |
NPI | 1073852182 |
---|---|
Provider Name | Lauren Marie Ott |
First Address | Huntington, WV 25701-4937 |
Second Address | Huntington, WV 25701-4937 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2013 |
Last Update Date | 08/02/2013 |