MEDICARE: HOPE MARIE OTTO LPC-INTERN, NCC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	83682	TX

General Provider Information

NPI Number	:	1881223113
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOPE MARIE OTTO LPC-INTERN, NCC

Provider Business Mailing Address
First Line	:	3718 GRAND HILLS LN
Second Line	:
City	:	FRIENDSWOOD
State	:	TX
Zip	:	77546-5369
Country	:	US
Telephone Number	:	281-993-4908
Fax Number	:

Provider Business Practice Location Address
First Line	:	3718 GRAND HILLS LN
Second Line	:
City	:	FRIENDSWOOD
State	:	TX
Zip	:	77546-5369
Country	:	US
Telephone Number	:	832-569-2151
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2020
Last Update Date	:	04/07/2020

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