Provider Demographics
NPI:1518638501
Name:OTTO, JEANNE RAMSEY
Entity Type:Individual
Prefix:MS
First Name:JEANNE
Middle Name:RAMSEY
Last Name:OTTO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2920 ROUND ROCK RANCH BLVD
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-7820
Mailing Address - Country:US
Mailing Address - Phone:512-626-1286
Mailing Address - Fax:
Practice Address - Street 1:2920 ROUND ROCK RANCH BLVD
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665-7820
Practice Address - Country:US
Practice Address - Phone:512-626-1286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-21
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16164235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist