Individual
MR. BRUCE ADAM OTTENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PLPC
Contact information
Practice address
1300 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4264
(417) 761-5000
Mailing address
1300 E BRADFORD PKWY, SPRINGFIELD, MO 65804-4264
(417) 761-5000
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2013005641
MO
Other
Enumeration date
05/20/2013
Last updated
05/20/2013
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