Healthcare Provider Details

I. General information

NPI: 1477474682
Provider Name (Legal Business Name): ANDREA ARNELL SCOTT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 WEBSTER SQUARE RD
BERLIN CT
06037-2326
US

IV. Provider business mailing address

225 CROWN ST
MERIDEN CT
06450-6468
US

V. Phone/Fax

Practice location:
  • Phone: 203-608-0184
  • Fax:
Mailing address:
  • Phone: 203-302-8425
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number006734
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: