Individual
CARL H OTHOLT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BSW
Contact information
Practice address
711 E 3RD AVE, SPOKANE, WA 99202-2211
(877) 266-1818
(509) 363-2762
Mailing address
107 S DIVISION ST, SPOKANE, WA 99202-1510
(509) 838-4651
(509) 363-2762
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CG61012444
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/15/2019
Last updated
04/06/2021
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