Individual
AMY SUZANNE OTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
595 ROUND ROCK WEST DR STE 104, ROUND ROCK, TX 78681-5028
(512) 815-3723
Mailing address
8026 WHITWORTH LN, ROUND ROCK, TX 78681-3416
(512) 944-2751
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
72064
TX
Other
Enumeration date
03/14/2017
Last updated
03/22/2019
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