Individual
MELISSA NICHOLE OTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PPS
Contact information
Practice address
12000 N VIRGINIA AVE, OKLAHOMA CITY, OK 73120-7581
(405) 835-6757
(405) 213-1628
Mailing address
2521 NW 115TH PL, OKLAHOMA CITY, OK 73120-6901
(405) 778-1691
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
1447794011
OK
101YS0200X
School Counselor
—
CA
101YS0200X
School Counselor
—
OK
103TS0200X
School Psychologist
—
CA
103TS0200X
School Psychologist
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235535352
NPI
OK
Enumeration date
12/15/2016
Last updated
07/21/2022
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