Individual
SUSAN MARGARET OTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
2 SHAKER RD STE D221, SHIRLEY, MA 01464-2535
(978) 425-0772
Mailing address
110 N MAIN ST, PETERSHAM, MA 01366-9501
(978) 724-8892
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
4249
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4249
MA PSYCHOLOGIST
MA
Enumeration date
05/24/2018
Last updated
05/24/2018
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