Individual
KELLY L OTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12466 HIGHWAY 24, MADISON, MO 65263-2150
(660) 291-8102
(660) 291-5338
Mailing address
12466 HIGHWAY 24, MADISON, MO 65263-2150
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
HE108783
MO
Other
Enumeration date
08/09/2010
Last updated
08/09/2010
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