Provider Demographics
NPI:1437369592
Name:SCOTTI, DAWN (PTA)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:SCOTTI
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15062 N 172ND LN
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85388-7824
Mailing Address - Country:US
Mailing Address - Phone:623-826-0086
Mailing Address - Fax:
Practice Address - Street 1:10235 S 51ST ST STE 170
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-5221
Practice Address - Country:US
Practice Address - Phone:480-889-3206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0208A225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant