Individual
SHAMIKA OTTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
7777 FOREST LN STE C833, DALLAS, TX 75230-2591
(972) 566-4591
Mailing address
7777 FOREST LN STE C833, DALLAS, TX 75230-2591
(972) 566-4591
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP144268
TX
Other
Enumeration date
01/16/2020
Last updated
01/16/2020
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