Provider Demographics
NPI:1730373150
Name:OTTO, FRANCES M (MS, CCC-SLP,MOT)
Entity type:Individual
Prefix:MS
First Name:FRANCES
Middle Name:M
Last Name:OTTO
Suffix:
Gender:F
Credentials:MS, CCC-SLP,MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 RANCH ROAD 3237
Mailing Address - Street 2:
Mailing Address - City:WIMBERLEY
Mailing Address - State:TX
Mailing Address - Zip Code:78676-5311
Mailing Address - Country:US
Mailing Address - Phone:512-847-5540
Mailing Address - Fax:512-847-0419
Practice Address - Street 1:555 RANCH ROAD 3237
Practice Address - Street 2:
Practice Address - City:WIMBERLEY
Practice Address - State:TX
Practice Address - Zip Code:78676-5311
Practice Address - Country:US
Practice Address - Phone:512-847-5540
Practice Address - Fax:512-847-0419
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-29
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXOT#104729225X00000X
ARSP#2399235Z00000X
TX106544235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR164266721Medicaid