Provider Demographics
NPI:1750911038
Name:OTT-OCHELTREE, MICHELE (NDTR)
Entity type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:
Last Name:OTT-OCHELTREE
Suffix:
Gender:F
Credentials:NDTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 VALLEY FORGE DR
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TWP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-5767
Mailing Address - Country:US
Mailing Address - Phone:724-779-1932
Mailing Address - Fax:
Practice Address - Street 1:900 3RD AVE
Practice Address - Street 2:
Practice Address - City:BEAVER FALLS
Practice Address - State:PA
Practice Address - Zip Code:15010-4613
Practice Address - Country:US
Practice Address - Phone:724-846-8504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-25
Last Update Date:2020-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes136A00000XDietary & Nutritional Service ProvidersDietetic Technician, Registered