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NPI Profile for LEEANN OTTO in WALTON, NY.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
School |
163WS0200X |
| NPI # | 1164973962 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 10/18/2016 | |
| Last updated | 10/18/2016 - About 10 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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LEEANN OTTO
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LEEANN OTTO