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General NPI Number Information
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NPI Number | 1689321150
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Entity Type | Individual
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Provider Name | JANIA OTTO
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Gender | Female
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Dates
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Enumeration Date | 03/04/2022
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Last Update Date | 03/04/2022
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Provider Practice Location Address
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Address Line | 349 W COMMERCIAL ST STE 2195
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City | EAST ROCHESTER
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State | NY
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Zip | 14445-2414
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Country | US
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Telephone | 585-562-9154
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Fax |
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Provider Business Mailing Address
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Address Line | 251 LANDING RD S
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City | ROCHESTER
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State | NY
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Zip | 14610-3564
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Country | US
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Telephone | 585-705-6590
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 221700000X
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Taxonomy Name | Art Therapist
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License Number | 002469-01
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License Number State | NY
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