Individual
AMY OTTERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
4721 BLACK MOUNTAIN PATH, RALEIGH, NC 27612-8603
(919) 521-2178
Mailing address
4721 BLACK MOUNTAIN PATH, RALEIGH, NC 27612-8603
(919) 521-2178
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
10532
NC
Other
Enumeration date
07/30/2013
Last updated
02/11/2014
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