| Organization Name: | JAMES M OTTESEN PHD INC |
| NPI Number: | 1720186307 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAMES M OTTESEN (PRESIDENT) |
| Mailing Address: | 640 East 700 South Suite 207 St. George |
| State: | UT US |
| Postal Code: | 847705293 |
| Phone Number: | 4356520322 |
| Fax Number: | 4356520350 |
| NPI Enumeration Date: | 09/20/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 325458-2501 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |