Individual
HAILEY KRISTINE OTTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4215 31ST AVE S STE A, FARGO, ND 58104-7743
(701) 478-0221
Mailing address
504 7TH ST NE, DILWORTH, MN 56529-1103
(701) 552-0753
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-322486
—
174400000X
Specialist
—
—
Other
Enumeration date
01/19/2024
Last updated
05/17/2024
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