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NPI Code Detail

MEDICARE: MRS. LISA A OTTOLINI MSW, LCSW

MEDICARE: MRS. LISA A OTTOLINI MSW, LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251B00000XCase Management Agency2005002449MO

General Provider Information

NPI Number : 1164447611
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LISA A OTTOLINI MSW, LCSW
Provider Business Mailing Address
First Line : 8631 DELMAR BLVD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63124-1990
Country : US
Telephone Number : 314-754-2800
Fax Number : 314-754-2800
Provider Business Practice Location Address
First Line : 8631 DELMAR BLVD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63124-1990
Country : US
Telephone Number : 314-787-5100
Fax Number : 314-754-2800
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2006
Last Update Date : 07/08/2007

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Directions to “ MRS. LISA A OTTOLINI MSW, LCSW” Practice Location

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