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Organization

OTTENBREIT PSYCHOTHERAPY ASSOCIATES, LLC

Active
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Organization

OTTENBREIT PSYCHOTHERAPY ASSOCIATES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BRUCE D. OTTENBREIT LMSW, ASCW (CLINICAL SOCIAL WORKER)
(313) 575-6297
Entity
Organization

Contact information

Practice address
835 MASON ST, B-200, DEARBORN, MI 48124-2231
(313) 575-6297
(313) 406-4617
Mailing address
835 MASON ST, B-200, DEARBORN, MI 48124-2231
(313) 575-6297
(313) 406-4617

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
MSW-6801007603
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12313056
QAQH
—
Enumeration date
11/04/2016
Last updated
12/05/2016
About Stedi
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