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Individual
TRACI J OTTO
Active
Individual
TRACI J OTTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
905
NE
101YA0400X
Addiction (Substance Use Disorder) Counselor
LISAC-15036
AZ
101YM0800X
Mental Health Counselor
3011
NE
101YM0800X
Mental Health Counselor
436
NE
101YM0800X
Mental Health Counselor
Primary
LPC-15542
AZ
Other
Enumeration date
10/13/2006
Last updated
12/16/2015
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