MEDICARE: DEBBIE TILTON OTRL INC

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist
2	225100000X	Physical Therapist
3	225XM0800X	Mental Health Occupational Therapist
4	225X00000X	Occupational Therapist	0127	NV

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1740323674
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEBBIE TILTON OTRL INC

Provider Business Mailing Address
First Line	:	11091 KILKERRAN CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89141-4356
Country	:	US
Telephone Number	:	702-381-1839
Fax Number	:

Provider Business Practice Location Address
First Line	:	11091 KILKERRAN CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89141-4356
Country	:	US
Telephone Number	:	702-381-1839
Fax Number	:

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	DEANNA YATES
Credential	:
Telephone Number	:	702-655-2455

Provider Enumeration Date	:	02/14/2007
Last Update Date	:	09/24/2025

11103 KILKERRAN CT
LAS VEGAS, NV
89141-4356

Practice Phone: 702-614-4576
Practice Fax: 702-614-4576