Individual
MATTHEW OTTENWELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4500 HUGH HOWELL RD STE 410, TUCKER, GA 30084-4732
(404) 594-2940
Mailing address
838 BARTON WOODS RD NE, ATLANTA, GA 30307-1306
(720) 365-7767
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
MSW006423
GA
1041C0700X
Clinical Social Worker
Primary
CSW006135
GA
Other
Enumeration date
12/09/2016
Last updated
03/29/2024
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