Healthcare Provider Details

I. General information

NPI: 1073652889
Provider Name (Legal Business Name): DEANNA HOWARD SCOTT OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

856 HENDERSON DR
LEXINGTON KY
40515-6464
US

IV. Provider business mailing address

272 ZANDALE DR
LEXINGTON KY
40503-2660
US

V. Phone/Fax

Practice location:
  • Phone: 859-539-2844
  • Fax: 859-272-7311
Mailing address:
  • Phone: 859-277-7499
  • Fax: 859-272-7311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberR1233
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: