Travis Lewellen Otto PSY.D.

NPI 1093065955 - Psychologist - 103TC0700X

NPI Details
NPI 1093065955
Gender Male
Enumeration Date 09/18/2012
Last Updated 09/16/2014
Entity Type Individual
Active Over 4 years ago
Practice Location
2505 CROWDER LN
TAMPA FL, 33629-6253, US
Phone (813) 361-4809
Fax
Business Location
6225 WILLET CT
LAKEWOOD RANCH FL, 34202-8224, US
Phone (813) 361-4809
Fax
Toxanomy
Taxonomy Code 103TC0700X
License State Florida
License Number PY8595
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According to our database, Mr. Travis Lewellen Otto PSY.D. NPI is 1093065955, taxonomy code is 103TC0700X and license number is PY8595, license state is located at Florida. Travis Lewellen Otto PSY.D. physically located at 2505 Crowder Ln, Tampa FL, 33629-6253. NPI Number Travis Lewellen Otto PSY.D. has the Individual type.

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1093065955 NPI number is provided on an as is basis without warranty of any kind. 1093065955 is maintained by the National Plan & Provider Enumeration System. The contents of Travis Lewellen Otto PSY.D. are for informational purposes only.