Provider Demographics
NPI:1013090794
Name:OTTINGER, HARLENE (BA)
Entity Type:Individual
Prefix:
First Name:HARLENE
Middle Name:
Last Name:OTTINGER
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:R
Other - Middle Name:HARLENE
Other - Last Name:OTTINGER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BA
Mailing Address - Street 1:PO BOX 9054
Mailing Address - Street 2:
Mailing Address - City:GRAY
Mailing Address - State:TN
Mailing Address - Zip Code:37615-9054
Mailing Address - Country:US
Mailing Address - Phone:423-467-3600
Mailing Address - Fax:423-467-3696
Practice Address - Street 1:616 E CHURCH ST
Practice Address - Street 2:CHURCH STREET PAVILION
Practice Address - City:GREENVILLE
Practice Address - State:TN
Practice Address - Zip Code:37743
Practice Address - Country:US
Practice Address - Phone:423-639-3213
Practice Address - Fax:423-639-4692
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator