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General NPI Number Information
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NPI Number | 1376405209
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Entity Type | Organization
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Legal Business Name | OTP SERVICES, LLC
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Dates
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Enumeration Date | 12/01/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 10580 S VINEWOOD RD W 92
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City | ROANOKE
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State | IN
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Zip | 46783-9228
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Country | US
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Telephone | 260-385-3540
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Fax |
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Provider Business Mailing Address
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Address Line | 10580 S VINEWOOD RD W 92
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City | ROANOKE
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State | IN
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Zip | 46783-9228
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Country | US
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Telephone | 260-385-3540
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JILL DIANE FORTE
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Credential | PH.D.
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Telephone | 260-385-3540
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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