Individual
CANDICE OTTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
619 N MAIN ST, MUSKOGEE, OK 74401-4431
(903) 456-7672
Mailing address
705 S COBB AVE, WAGONER, OK 74467-6721
(903) 456-7672
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/04/2025
Last updated
08/04/2025
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