Doctor Name: | EVA M OTTESEN |
NPI Number: | 1063566495 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 0287701-R |
Business Practice Address: | 246 State Rt 208 New Paltz, NY - 12561 |
Business Phone Number: | 8452552658 |
Business Fax Number: | |
Mailing Address: | 246 State Route 208, NEW PALTZ |
State: | NY |
Postal Code: | 125612704 |
Phone Number: | 8452552658 |
Fax Number: | |
NPI Enumeration Date: | 01/23/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 0287701-R |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |