Individual
JENNIFER VAN OTTEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
1211 COLIBRI AVE NW, LOS LUNAS, NM 87031-7441
(505) 865-5301
Mailing address
1211 COLIBRI AVE NW, LOS LUNAS, NM 87031-7441
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
02/25/2009
Last updated
02/25/2009
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