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NPI Code Detail

MEDICARE: SAMANTHA ANGELINE OTTNEY

MEDICARE: SAMANTHA ANGELINE OTTNEY
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
11041C0700XClinical Social WorkerS.1802545OH

General Provider Information

NPI Number : 1831675370
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA ANGELINE OTTNEY
Provider Business Mailing Address
First Line : 774 INTERNET DR
Second Line :
City : COLUMBUS
State : OH
Zip : 43207-2589
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 774 INTERNET DR
Second Line :
City : COLUMBUS
State : OH
Zip : 43207-2589
Country : US
Telephone Number : 614-443-5454
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2018
Last Update Date : 07/18/2018

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Directions to “ SAMANTHA ANGELINE OTTNEY ” Practice Location

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