Individual
DR. SUMMER D. OTT
Active
Individual
DR. SUMMER D. OTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
33628
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1043406655
BLUE CROSS BLUE SHIELD
TX
05
—
192738601
—
TX
05
—
192738602
—
TX
01
—
87447A
BCBS TX
TX
Enumeration date
09/18/2007
Last updated
05/09/2012
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