Provider Demographics
NPI:1497107106
Name:J. OTTO CONSULTING
Entity Type:Organization
Organization Name:J. OTTO CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAQUI
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:OTTO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:817-492-5105
Mailing Address - Street 1:111 QUEST CT
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-3748
Mailing Address - Country:US
Mailing Address - Phone:817-492-5105
Mailing Address - Fax:
Practice Address - Street 1:111 QUEST CT
Practice Address - Street 2:
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-3748
Practice Address - Country:US
Practice Address - Phone:817-492-5105
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-06
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty