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NPI Code Detail

MEDICARE: MS. DIANA M OTTNEY L.S.W.

MEDICARE: MS. DIANA M OTTNEY L.S.W.
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 1450864OH

General Provider Information

NPI Number : 1942757091
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DIANA M OTTNEY L.S.W.
Provider Business Mailing Address
First Line : 1832 ADAMS ST
Second Line :
City : TOLEDO
State : OH
Zip : 43604-4428
Country : US
Telephone Number : 419-299-8329
Fax Number :
Provider Business Practice Location Address
First Line : 1832 ADAMS ST
Second Line :
City : TOLEDO
State : OH
Zip : 43604-4428
Country : US
Telephone Number : 419-299-8329
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2016
Last Update Date : 09/07/2016

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