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General NPI Number Information
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NPI Number | 1821733908
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Entity Type | Organization
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Legal Business Name | DR AMY SUE OTT PHD FAMILY COUNSELING SERVICE PLLC
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Dates
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Enumeration Date | 05/03/2022
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Last Update Date | 05/03/2022
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Provider Practice Location Address
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Address Line | 2316 JODI LN
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City | GAINESVILLE
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State | TX
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Zip | 76240-2446
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Country | US
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Telephone | 940-368-7176
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Fax | 940-580-3617
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Provider Business Mailing Address
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Address Line | 2316 JODI LN
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City | GAINESVILLE
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State | TX
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Zip | 76240-2446
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Country | US
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Telephone | 940-368-7176
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMY SUE PATRICK-OTT
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Credential | PHD
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Telephone | 940-368-7176
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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