Individual
JOANNA LEE OTIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RDN, CD, CNSC
Contact information
Practice address
600 HIGHLAND AVE, COMPLIANCE MC 2433, MADISON, WI 53792-0001
(608) 263-8230
(608) 262-1636
Mailing address
600 HIGHLAND AVE # 1510, MADISON, WI 53792-0001
(608) 333-9501
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2223
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2223-029
CERTIFIED DIETITIAN
—
Enumeration date
01/20/2010
Last updated
02/20/2024
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