Healthcare Provider Details

I. General information

NPI: 1902721756
Provider Name (Legal Business Name): LAUREN SCAMACCA OTR, OTD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1062 WOODLAKE LN
TEGA CAY SC
29708-8559
US

IV. Provider business mailing address

1028 CURRITUCK WAY
YORK SC
29745-2887
US

V. Phone/Fax

Practice location:
  • Phone: 704-840-2509
  • Fax:
Mailing address:
  • Phone: 803-374-9732
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number556098
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: