Provider Demographics
NPI:1477927879
Name:SCOTT, JOSEPH (COTA)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:SCOTT
Suffix:
Gender:M
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7990 HAWKINSMITH RD
Mailing Address - Street 2:
Mailing Address - City:JUNCTION CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66441-7583
Mailing Address - Country:US
Mailing Address - Phone:901-614-6727
Mailing Address - Fax:
Practice Address - Street 1:7990 HAWKINSMITH RD
Practice Address - Street 2:
Practice Address - City:JUNCTION CITY
Practice Address - State:KS
Practice Address - Zip Code:66441-7583
Practice Address - Country:US
Practice Address - Phone:901-614-6727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-23
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS18-01178224Z00000X
MSTA3046224Z00000X
TX213589224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant