| Doctor Name: | AMY BETH OTZEL |
| NPI Number: | 1154747699 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | 002098 |
| Business Practice Address: | 392 S Main St Suite 7 Colchester, CT - 064151458 |
| Business Phone Number: | 8606032658 |
| Business Fax Number: | 8606032659 |
| Mailing Address: | 392 S Main St, Suite 7 COLCHESTER |
| State: | CT |
| Postal Code: | 064151458 |
| Phone Number: | 8606032658 |
| Fax Number: | 8606032659 |
| NPI Enumeration Date: | 03/07/2014 |
| NPI Last Update Date: | 02/04/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 002098 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |