Individual
KATHRYN OETTING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12500 MEADOWLARK LN, CEDAR LAKE, IN 46303-9288
(313) 343-0653
Mailing address
12500 MEADOWLARK LN, CEDAR LAKE, IN 46303-9288
(313) 343-0653
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
1559809
IN
103TS0200X
School Psychologist
1855814
IL
Other
Enumeration date
07/26/2022
Last updated
07/26/2022
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