Individual
BETHANY OTT
Active
Individual
BETHANY OTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC MHSP
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
APC003099
GA
101YP2500X
Professional Counselor
Primary
3555
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q018428
—
TN
Enumeration date
03/06/2012
Last updated
01/08/2021
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