Provider Demographics
NPI:1457500548
Name:SCOTT, MARINA (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:MARINA
Middle Name:
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 N MAIN ST UNIT 224
Mailing Address - Street 2:
Mailing Address - City:OLD SAYBROOK
Mailing Address - State:CT
Mailing Address - Zip Code:06475-4242
Mailing Address - Country:US
Mailing Address - Phone:203-524-3236
Mailing Address - Fax:
Practice Address - Street 1:7 N MAIN ST UNIT 224
Practice Address - Street 2:
Practice Address - City:OLD SAYBROOK
Practice Address - State:CT
Practice Address - Zip Code:06475-4242
Practice Address - Country:US
Practice Address - Phone:203-524-3236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-12
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002767225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist