Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | U1-0000835 | DE |
NPI | 1063648715 |
---|---|
Provider Name | Laurie Scott |
First Address | Newark, DE 19702-3762 |
Second Address | Newark, DE 19702-3970 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2009 |
Last Update Date | 09/06/2009 |