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General NPI Number Information
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NPI Number | 1689814485
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Entity Type | Individual
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Provider Name | STACIE D. OTEY-SCOTT PSY.D
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Gender | Female
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Dates
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Enumeration Date | 03/06/2009
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Last Update Date | 11/01/2023
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Provider Practice Location Address
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Address Line | 5326 CENTER ST
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City | WILLIAMSBURG
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State | VA
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Zip | 23188-2815
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Country | US
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Telephone | 757-533-2334
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Fax | 757-994-1511
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Provider Business Mailing Address
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Address Line | 5326 CENTER ST
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City | WILLIAMSBURG
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State | VA
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Zip | 23188-2815
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Country | US
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Telephone | 757-533-2334
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Fax | 757-994-1511
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0810004079
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License Number State | VA
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