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General NPI Number Information
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NPI Number | 1225628746
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Entity Type | Individual
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Provider Name | MARIA J OTERO BCBA
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Gender | Female
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Dates
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Enumeration Date | 01/19/2021
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Last Update Date | 06/17/2024
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Provider Practice Location Address
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Address Line | 1300 W LANCASTER AVE STE 205
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City | FORT WORTH
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State | TX
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Zip | 76102-3499
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Country | US
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Telephone | 682-303-9200
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Fax | 682-303-9239
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Provider Business Mailing Address
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Address Line | 1300 W LANCASTER AVE STE 205
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City | FORT WORTH
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State | TX
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Zip | 76102-3499
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Country | US
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Telephone | 682-303-9200
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Fax | 682-303-9239
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 3864
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License Number State | TX
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