MEDICARE: MS. FRANCES M OTTO MS, CCC-SLP,MOT

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
1	225X00000X	Occupational Therapist	OT#104729	TX
2	235Z00000X	Speech-Language Pathologist	SP#2399	AR
3	235Z00000X	Speech-Language Pathologist	106544	TX

Other Identifiers

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

General Provider Information

NPI Number	:	1730373150
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. FRANCES M OTTO MS, CCC-SLP,MOT

Provider Business Mailing Address
First Line	:	555 RANCH ROAD 3237
Second Line	:
City	:	WIMBERLEY
State	:	TX
Zip	:	78676-5311
Country	:	US
Telephone Number	:	512-847-5540
Fax Number	:	512-847-0419

Provider Business Practice Location Address
First Line	:	555 RANCH ROAD 3237
Second Line	:
City	:	WIMBERLEY
State	:	TX
Zip	:	78676-5311
Country	:	US
Telephone Number	:	512-847-5540
Fax Number	:	512-847-0419

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2007
Last Update Date	:	06/27/2011

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