Individual
MR. MATTHEW IRA OTTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.C.P.C.
Contact information
Practice address
10774 HICKORY RIDGE RD, COLUMBIA, MD 21044-3646
(410) 997-7288
(410) 997-2880
Mailing address
6835 WOODCREST RD, NEW MARKET, MD 21774-2946
(410) 997-7288
(410) 997-2880
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC4279
MD
Other
Enumeration date
01/04/2012
Last updated
01/04/2012
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