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Stacey Otto
Mental Health Counselor in Oshkosh, Wisconsin
NPI 1871651299

Stacey Otto is a Mental Health Counselor based in Oshkosh, WI and is specialized in Mental Health. Stacey Otto practices in Oshkosh, WI. The NPI Number for Stacey Otto is 1871651299 and holds a License No. 6910-123 (Wisconsin).

The current practice location address for Stacey Otto is 220 Washington Avenue, Oshkosh, WI and can be reached out via phone at 920-236-4600.

Location: 220 Washington Avenue, Oshkosh, WI, 54903-2187
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1871651299
Provider Name
Stacey Otto
Credential
Provider Entity Type
Individual
Gender
Female
Address
220 Washington Avenue, Oshkosh, WI, 54903-2187
Phone Number
920-236-4600
Fax Number
Provider Enumeration Date
12/05/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
42156000 05 WI
42139300 05 WI
institution
Provider Business Practice Location Address Details
Address
220 Washington Avenue
City
Oshkosh
State
Wisconsin
Zip
54901
Phone Number
920-236-4600
Fax Number
person
Provider Business Mailing Address Details
Address
220 Washington Avenue
City
Oshkosh
State
Wisconsin
Zip
54901
Phone Number
920-236-4600
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
6910-123 (Wisconsin)
Definition
Definition to come...
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