Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 10242 | NC |
NPI | 1053773655 |
---|---|
Provider Name | Ashley Lynn Scott |
First Address | Concord, NC 28027-3711 |
Second Address | Concord, NC 28027-3711 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2016 |
Last Update Date | 23/03/2016 |