Provider Demographics
NPI:1346801669
Name:HOTTOVY, JANELLE LYN (MSW)
Entity Type:Individual
Prefix:
First Name:JANELLE
Middle Name:LYN
Last Name:HOTTOVY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:JANELLE
Other - Middle Name:LYN
Other - Last Name:HOTTOVY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:4316 E 52ND ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-3909
Mailing Address - Country:US
Mailing Address - Phone:918-230-4542
Mailing Address - Fax:
Practice Address - Street 1:650 S PEORIA AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74120-4429
Practice Address - Country:US
Practice Address - Phone:918-587-9471
Practice Address - Fax:918-560-1399
Is Sole Proprietor?:No
Enumeration Date:2019-06-26
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker