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General NPI Number Information
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NPI Number | 1831885458
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Entity Type | Individual
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Provider Name | OTTERIA TRIMBLE PSYD,
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Gender | Female
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Dates
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Enumeration Date | 04/17/2023
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 11900 PENNSYLVANIA ST STE 104
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City | CARMEL
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State | IN
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Zip | 46032-4694
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Country | US
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Telephone | 216-468-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 4800 N SCOTTSDALE RD STE 2500
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-7630
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Country | US
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Telephone | 216-468-5000
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 20043560B
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License Number State | IN
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