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General NPI Number Information
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NPI Number | 1962442830
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Entity Type | Individual
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Provider Name | JAMES CURTIS OTTESON LPC
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Gender | Male
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Dates
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Enumeration Date | 06/07/2006
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Last Update Date | 02/13/2012
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Provider Practice Location Address
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Address Line | 71 N 490 W
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City | AMERICAN FORK
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State | UT
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Zip | 84003-2264
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Country | US
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Telephone | 801-763-7775
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Fax | 801-763-7651
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Provider Business Mailing Address
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Address Line | 4475 W WINDSOR ST
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City | CEDAR HILLS
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State | UT
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Zip | 84062
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Country | US
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Telephone | 801-205-2744
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Fax | 801-763-7651
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 3406966004
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License Number State | UT
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