Provider Demographics
NPI:1215395140
Name:SCOTT, DANIELLE
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6915 LAUREL BOWIE RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-1703
Mailing Address - Country:US
Mailing Address - Phone:240-245-4370
Mailing Address - Fax:
Practice Address - Street 1:9565 HWY 78 BLDG 700
Practice Address - Street 2:SUITE 102
Practice Address - City:LADSON
Practice Address - State:SC
Practice Address - Zip Code:29456-4116
Practice Address - Country:US
Practice Address - Phone:843-314-5434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD235450225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist