Individual provider Active NPI

Jo-Ann Otlin, MA,CCC

  • Speech-Language Pathologist
  • Milford, MA
National Provider Identifier
1013067834
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1085 Issued in MA
Practice address
345 Fortune Blvd
Milford, MA 01757-1723
Phone
(508) 473-3422
Fax
(508) 473-0994
NPI assigned
Jan 12, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 1085 MA Primary

Addresses

Primary practice location

345 Fortune Blvd
Milford, MA 01757-1723

Mailing address

19 Salvia Dr
Milford, MA 01757-1840
Phone (508) 473-4670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
1085MAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Criterion Child Enrichment, Inc. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013067834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 SALVIA DR",
            "city": "MILFORD",
            "state": "MA",
            "postal_code": "017571840",
            "telephone_number": "508-473-4670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 FORTUNE BLVD",
            "city": "MILFORD",
            "state": "MA",
            "postal_code": "017571723",
            "telephone_number": "508-473-3422",
            "fax_number": "508-473-0994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OTLIN",
        "first_name": "JO-ANN",
        "name_prefix": "Ms.",
        "credential": "MA,CCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "1085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milford, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.