Individual
CHRISTINA OTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MACCC, SLP
Contact information
Practice address
890 N COLE RD, SUITE A, BOISE, ID 83704-8638
(208) 323-8888
(208) 323-8889
Mailing address
7334 GILLIS RD, BOISE, ID 83714-5016
(208) 853-1772
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP1460
ID
Other
Enumeration date
09/19/2007
Last updated
09/19/2007
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