Individual
JOSEPH HAROLD OTTERSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 CRAFTON ST, APT F-3, TAHLEQUAH, OK 74464-7112
(918) 402-4666
Mailing address
800 CRAFTON ST, APT F-3, TAHLEQUAH, OK 74464-7112
(918) 402-4666
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
01/13/2012
Last updated
01/13/2012
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