Provider Demographics
NPI:1518441021
Name:SCOTT, NAZRIN DIXON ROBERSON (OTR/L)
Entity Type:Individual
Prefix:
First Name:NAZRIN
Middle Name:DIXON ROBERSON
Last Name:SCOTT
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3969 BIG HILL RD
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON GAP
Mailing Address - State:VA
Mailing Address - Zip Code:24277-8320
Mailing Address - Country:US
Mailing Address - Phone:757-784-7840
Mailing Address - Fax:
Practice Address - Street 1:2045 VALLEY VIEW DR
Practice Address - Street 2:
Practice Address - City:BIG STONE GAP
Practice Address - State:VA
Practice Address - Zip Code:24219-3319
Practice Address - Country:US
Practice Address - Phone:275-523-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-20
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119007529225X00000X
VA0119006529225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist