Individual
JACOB S OTTMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCMHC
Contact information
Practice address
3844 CLEMMONS RD, CLEMMONS, NC 27012-7532
(336) 866-0537
Mailing address
480 ESSEN PL, KERNERSVILLE, NC 27284-8332
(202) 823-2139
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A17819
NC
Other
Enumeration date
08/22/2022
Last updated
01/27/2026
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