Provider Demographics
NPI:1184647406
Name:OTTO, DAVID WILLIAM (MME, MT-BC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:WILLIAM
Last Name:OTTO
Suffix:
Gender:M
Credentials:MME, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1139 BOHEMIA MILL RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-9755
Mailing Address - Country:US
Mailing Address - Phone:302-464-2538
Mailing Address - Fax:
Practice Address - Street 1:810 VERMONT AVE NW RM 667
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20420-1524
Practice Address - Country:US
Practice Address - Phone:202-461-4547
Practice Address - Fax:202-461-5473
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist