Healthcare Provider Details

I. General information

NPI: 1740323674
Provider Name (Legal Business Name): DEBBIE TILTON OTRL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11091 KILKERRAN CT
LAS VEGAS NV
89141-4356
US

IV. Provider business mailing address

11091 KILKERRAN CT
LAS VEGAS NV
89141-4356
US

V. Phone/Fax

Practice location:
  • Phone: 702-381-1839
  • Fax:
Mailing address:
  • Phone: 702-381-1839
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225XM0800X
TaxonomyMental Health Occupational Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number0127
License Number StateNV

VIII. Authorized Official

Name: DEANNA YATES
Title or Position: BILLING MANAGER
Credential:
Phone: 702-655-2455