Individual
DR. JAMES PAUL OTTESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D., LP
Contact information
Practice address
209 E MILL ST, OWATONNA, MN 55060-3008
(507) 446-0002
(507) 451-8003
Mailing address
209 E MILL ST, OWATONNA, MN 55060-3008
(507) 446-0002
(507) 451-8003
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP4284
MN
103TF0200X
Forensic Psychologist
LP4284
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
048L8OT
BCBS
MN
01
—
LP4284
LICENSED PSYCHOLOGIST
MN
Enumeration date
02/08/2007
Last updated
10/23/2007
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