Individual
SHANA OTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
120 E 9TH AVE, COLLEGEVILLE, PA 19426-2318
(484) 744-3018
Mailing address
120 E 9TH AVE, COLLEGEVILLE, PA 19426-2318
(484) 744-3018
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BH001399
PA
Other
Enumeration date
12/10/2015
Last updated
12/10/2015
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