Individual
NATASHA OTTERNESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
2900 CHARLEVOIX DR SE STE 200, GRAND RAPIDS, MI 49546-7086
(800) 684-8049
Mailing address
204 DIAMOND CV, DESTIN, FL 32541-3669
(850) 582-6495
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
103129
TX
235Z00000X
Speech-Language Pathologist
4491
WA
235Z00000X
Speech-Language Pathologist
Primary
SA7799
FL
Other
Enumeration date
06/25/2007
Last updated
09/11/2025
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