Individual
LYNAE JOY OTTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1713 WOODWIND WAY, VAN BUREN, AR 72956-2044
(712) 363-7942
Mailing address
1713 WOODWIND WAY, VAN BUREN, AR 72956-2044
(712) 363-7942
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
082139
IA
1041C0700X
Clinical Social Worker
Primary
5158-C
AR
1041C0700X
Clinical Social Worker
8233
OK
Other
Enumeration date
11/03/2008
Last updated
11/03/2021
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