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Individual

DR. DAVID ALLEN OTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
5201 RAYMOND ST, ORLANDO, FL 32803-8208
(407) 629-1599
Mailing address
3504 WOODLEY PARK PL, OVIEDO, FL 32765-5105
(407) 977-5871

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
5478
OH
103T00000X
Psychologist
PY7414
FL
103TB0200X
Cognitive & Behavioral Psychologist
5478
OH
103TB0200X
Cognitive & Behavioral Psychologist
PY7414
FL
103TC0700X
Clinical Psychologist
5478
OH
103TC0700X
Clinical Psychologist
Primary
PY7414
FL
103TC2200X
Clinical Child & Adolescent Psychologist
5478
OH
103TC2200X
Clinical Child & Adolescent Psychologist
PY7414
FL
103TF0200X
Forensic Psychologist
5478
OH
103TF0200X
Forensic Psychologist
PY7414
FL
103TM1800X
Intellectual & Developmental Disabilities Psychologist
5478
OH
103TM1800X
Intellectual & Developmental Disabilities Psychologist
PY7414
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000347111
ANTHEM
OH
05
2287047
OH
01
298511000
MAGELLAN
OH
Enumeration date
05/17/2006
Last updated
04/12/2012
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