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General NPI Number Information
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NPI Number | 1770734857
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Entity Type | Individual
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Provider Name | MARIEL MITCHELL OTT GEBHARDT LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/07/2008
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 2775 MACK BLVD
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City | FAIRBANKS
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State | AK
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Zip | 99709-4004
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Country | US
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Telephone | 907-251-7664
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 80355
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City | FAIRBANKS
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State | AK
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Zip | 99708-0355
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Country | US
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Telephone | 907-251-7664
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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