Individual
STACEY OTSUKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8001 MOUNTAIN ROAD PL NE, ALBUQUERQUE, NM 87110-7808
(505) 453-4083
Mailing address
6318 DONA LINDA PL NW, ALBUQUERQUE, NM 87120-3729
(505) 453-4083
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CMH0207931
NM
Other
Enumeration date
11/20/2019
Last updated
06/24/2024
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