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| Type | Person | [sources] | |||
|---|---|---|---|---|---|
| Name | TROY DAVID OTTERSON | [sources] | |||
| Birth date | not available | [sources] | |||
| Nationality | not available | [sources] | |||
| Country | United States of America | [sources] | |||
| First name | TROY | [sources] | |||
| Last name | OTTERSON | [sources] | |||
| Middle name | DAVID | [sources] | |||
| Sector | Licensed Independent Clinical Social Worker (LICSW) | [sources] | |||
| Address | 324 W SUPERIOR ST STE 300, DULUTH, MN 55802 | [sources] | |||
| Last change | Last processed | First seen | |||
Medical providers suspended or terminated from Minnesota Health Care Programs.
United States of America · MHCP
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| Sanctions | |||||
|---|---|---|---|---|---|
| Country | Authority | Program | Start date | End date | |
| United States of America | Medicaid authority · Minnesota Health Care Programs | - | |||
| Address | ||
|---|---|---|
| Full address | Country | |
| 324 W SUPERIOR ST STE 300, DULUTH, MN 55802 | United States of America | |