Provider Demographics
NPI:1689070765
Name:OTTING, ALLISON (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:
Last Name:OTTING
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1845 HADFIELD BLVD
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-1787
Mailing Address - Country:US
Mailing Address - Phone:614-327-2879
Mailing Address - Fax:
Practice Address - Street 1:1845 HADFIELD BLVD
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-1787
Practice Address - Country:US
Practice Address - Phone:614-327-2879
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-17
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP008550235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist