Individual
MR. EDWARD SCOTT OTTESEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
12471 N 75TH DR, PEORIA, AZ 85381-5208
(480) 882-8059
Mailing address
12471 N 75TH DR, PEORIA, AZ 85381-5208
(480) 882-8059
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
2077
AZ
101YM0800X
Mental Health Counselor
274970
AZ
101YP2500X
Professional Counselor
Primary
LPC-15869
AZ
Other
Enumeration date
11/05/2013
Last updated
12/05/2015
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