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Individual

MRS. SUE ELLEN OTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
O.T.R.

Contact information

Practice address
8400 BARSTOW ST NE, ALBUQUERQUE, NM 87122-2832
(505) 857-9282
(505) 857-0201
Mailing address
9305 OAKLAND AVE NE, ALBUQUERQUE, NM 87122-3813
(505) 828-3663
(505) 857-0201

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
981
NM

Other

Enumeration date
12/05/2006
Last updated
07/08/2007
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