Organization
MARIA L. OTT, PSY. D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA LISA OTT PSY.D. (CLINICAL PSYCHOLOGIST)
(719) 465-4340
Entity
Organization
Contact information
Practice address
2860 S CIRCLE DR, 100, COLORADO SPRINGS, CO 80906-4113
(719) 465-4340
Mailing address
6455 BLUFFMONT PT, COLORADO SPRINGS, CO 80923-8401
(719) 465-4340
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
3064
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
143191
—
CO
01
—
C811047
PTAN
CO
Enumeration date
01/31/2015
Last updated
02/23/2015
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