SUSAN OTT STAVIS

TIJERAS, NM
NPI1003766551
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Enumeration Date2026-02-02
Last Update Date2026-02-02
Business Address
SUSAN OTT STAVIS
25 CAMPO RD
TIJERAS, NM 87059-7615
Phone number: 208-818-4774
Mailing Address
SUSAN OTT STAVIS
25 CAMPO RD
TIJERAS, NM 87059-7615
Phone number: 208-818-4774
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