DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: SALLY OTT

MEDICARE: SALLY OTT
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1639024532
Entity Type Code : Individual
Provider Name (Legal Business Name) : SALLY OTT
Provider Business Mailing Address
First Line : 9480 THREE RIVERS RD
Second Line :
City : GULFPORT
State : MS
Zip : 39503-4248
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9480 THREE RIVERS RD
Second Line :
City : GULFPORT
State : MS
Zip : 39503-4248
Country : US
Telephone Number : 228-313-3106
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2026
Last Update Date : 03/04/2026

Similar Medicare Providers

1386599280 — CHLOE SCHULTZ
Practice Location Address:
9480 THREE RIVERS RD
GULFPORT, MS
39503-4248
Practice Phone: 251-802-4967
Practice Fax:
1831741818 — CRYSTAL SCHACKAI
Practice Location Address:
9480 THREE RIVERS RD
GULFPORT, MS
39503-4248
Practice Phone: 228-313-3106
Practice Fax:
1912559956 — CATHERINE DEBERRY RBT
Practice Location Address:
9480 THREE RIVERS RD
GULFPORT, MS
39503-4248
Practice Phone: 228-313-3106
Practice Fax:
1275185258 — KEELY PANKOPF RBT
Practice Location Address:
9480 THREE RIVERS RD
GULFPORT, MS
39503-4248
Practice Phone: 228-313-3106
Practice Fax:
1700438702 — KAYLI MAZZA RBT
Practice Location Address:
9480 THREE RIVERS RD
GULFPORT, MS
39503-4248
Practice Phone: 228-313-3106
Practice Fax:
1376195305 — CHARMAINE HALL RBT
Practice Location Address:
9480 THREE RIVERS RD
GULFPORT, MS
39503-4248
Practice Phone: 228-313-3106
Practice Fax:

Directions to “ SALLY OTT ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.