Individual
EMILY RUTH OTTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1425 BEMIS ST SE, GRAND RAPIDS, MI 49506-2752
(616) 915-9632
Mailing address
1425 BEMIS ST SE, GRAND RAPIDS, MI 49506-2752
(616) 915-9632
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
22007263A
IN
235Z00000X
Speech-Language Pathologist
Primary
7101005635
MI
Other
Enumeration date
09/23/2019
Last updated
09/23/2019
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