Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 004217-1 | NY |
NPI | 1013249135 |
---|---|
Provider Name | Colleen R Scott |
First Address | Penn Yan, NY 14527-1832 |
Second Address | Penn Yan, NY 14527-1832 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2010 |
Last Update Date | 01/02/2010 |