Provider Demographics
NPI:1902066079
Name:OETTINGER, ANTHONY ROBERTS (M ED NCC LPC)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:ROBERTS
Last Name:OETTINGER
Suffix:
Gender:M
Credentials:M ED NCC LPC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:916 SMITH ST
Mailing Address - Street 2:
Mailing Address - City:ALBEMARLE
Mailing Address - State:NC
Mailing Address - Zip Code:28001-3028
Mailing Address - Country:US
Mailing Address - Phone:704-983-1251
Mailing Address - Fax:704-991-0255
Practice Address - Street 1:141 COLLEGE DR
Practice Address - Street 2:STANLY COMMUNITY COLLEGE
Practice Address - City:ALBEMARLE
Practice Address - State:NC
Practice Address - Zip Code:28001-7458
Practice Address - Country:US
Practice Address - Phone:704-991-0236
Practice Address - Fax:704-991-0255
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-12
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC981101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional