Healthcare Provider Details

I. General information

NPI: 1346767480
Provider Name (Legal Business Name): SONYA SCOTT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1254 PICCADILLY ST. APT A
NORFOLK VA
23513
US

IV. Provider business mailing address

1254 PICADILLY ST APT A
NORFOLK VA
23513-1945
US

V. Phone/Fax

Practice location:
  • Phone: 757-376-5329
  • Fax:
Mailing address:
  • Phone: 757-376-5329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: