MEDICARE: MR. DAVID WILLIAM OTTO MME, MT-BC

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
1	225A00000X	Music Therapist

General Provider Information

NPI Number	:	1184647406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID WILLIAM OTTO MME, MT-BC

Provider Business Mailing Address
First Line	:	1139 BOHEMIA MILL RD
Second Line	:
City	:	MIDDLETOWN
State	:	DE
Zip	:	19709-9755
Country	:	US
Telephone Number	:	302-464-2538
Fax Number	:

Provider Business Practice Location Address
First Line	:	810 VERMONT AVE NW RM 667
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20420-1524
Country	:	US
Telephone Number	:	202-461-4547
Fax Number	:	202-461-5473

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	04/13/2021

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Directions to “ MR. DAVID WILLIAM OTTO MME, MT-BC” Practice Location

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