Individual
LISA OTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., BCBA
Contact information
Practice address
7001 E FISH LAKE RD, MAPLE GROVE, MN 55311-2841
(612) 578-8632
Mailing address
6458 CITY WEST PKWY, EDEN PRAIRIE, MN 55344-3245
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-13-13265
MN
103K00000X
Behavior Analyst
—
—
Other
Enumeration date
07/08/2016
Last updated
09/13/2023
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