Provider Demographics
NPI:1972015931
Name:OTERO, LUNA NATALIA (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:LUNA
Middle Name:NATALIA
Last Name:OTERO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16654 SW 55TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-5260
Mailing Address - Country:US
Mailing Address - Phone:787-340-9281
Mailing Address - Fax:
Practice Address - Street 1:16654 SW 55TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33185-5260
Practice Address - Country:US
Practice Address - Phone:787-340-9281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-31
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT3368106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist