Individual
CHRISTINE MARIE OTERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3662 CEDARCREST RD STE 220, ACWORTH, GA 30101-8765
(470) 531-0512
Mailing address
300 INTERNATIONAL PKWY STE 200, LAKE MARY, FL 32746-5028
(678) 978-5585
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265819965
—
GA
Enumeration date
05/01/2015
Last updated
01/31/2020
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