Healthcare Provider Details

I. General information

NPI: 1326902065
Provider Name (Legal Business Name): HANNAH RAQUEL SCOTT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2920 W BROAD ST STE 215
RICHMOND VA
23230-5103
US

IV. Provider business mailing address

1423 BULL RUN DR
HENRICO VA
23231-5162
US

V. Phone/Fax

Practice location:
  • Phone: 804-988-1150
  • Fax:
Mailing address:
  • Phone: 804-926-4915
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: