Individual
CANDICE LYNELL OTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA BHRS
Contact information
Practice address
113 W ADA AVE, WILBURTON, OK 74578-2416
(918) 297-3400
(918) 297-3401
Mailing address
113 W ADA AVE, WILBURTON, OK 74578-2416
(918) 297-3400
(918) 297-3401
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/13/2012
Last updated
09/13/2012
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