| The Mill Street House | |
|
209 E Mill St Owatonna MN 55060-3008 | |
| (507) 446-0002 | |
| (507) 451-8003 |
| Full Name | The Mill Street House |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 209 E Mill St, Owatonna, Minnesota |
| Authorized Official Name and Position | James Paul Otteson (LICENSED PSYCHOLOGIST) |
| Authorized Official Contact | 5074460002 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Mill Street House 209 E Mill St Owatonna MN 55060-3008 Ph: (507) 446-0002 | The Mill Street House 209 E Mill St Owatonna MN 55060-3008 Ph: (507) 446-0002 |
| NPI Number | 1194889352 |
|---|---|
| Provider Enumeration Date | 12/21/2006 |
| Last Update Date | 10/23/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194889352 | NPI | - | NPPES |
| 048L7OT | Other | MN | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | LP4284 (Minnesota) | Primary |
| 103TF0200X | Psychologist - Forensic | LP4284 (Minnesota) | Secondary |
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