Provider Demographics
NPI:1508105909
Name:SCOTT, JAMIE L (OT)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:L
Last Name:SCOTT
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1475
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50305-1475
Mailing Address - Country:US
Mailing Address - Phone:515-222-7350
Mailing Address - Fax:515-222-7355
Practice Address - Street 1:1601 NW 114TH ST.
Practice Address - Street 2:SUITE: 155
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-7046
Practice Address - Country:US
Practice Address - Phone:515-222-7385
Practice Address - Fax:515-222-7655
Is Sole Proprietor?:No
Enumeration Date:2013-02-05
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002303225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist