Individual
NICOLE CHRISTINE OTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6025 N GREEN BAY AVE UPPR LEVEL, GLENDALE, WI 53209-3811
(414) 247-0801
(414) 247-0816
Mailing address
6025 N GREEN BAY AVE UPPR LEVEL, GLENDALE, WI 53209-3811
(414) 247-0801
(414) 247-0816
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
10571
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10571
LICENSE
WI
Enumeration date
10/18/2021
Last updated
12/12/2023
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