Individual
DR. MARISSA LEIGH OTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
26NR18464300
NJ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
26NJ01333700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0
INSURANCE
NJ
Enumeration date
11/07/2019
Last updated
08/02/2022
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