Individual
NICOLE J OTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
720 8TH AVE N, SAINT CLOUD, MN 56303-3420
(320) 266-1693
(320) 251-0217
Mailing address
139 22ND AVE N, SAINT CLOUD, MN 56303-4331
(320) 266-1693
(320) 251-0217
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
2129
MN
Other
Enumeration date
09/13/2011
Last updated
08/27/2014
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