Provider Demographics
NPI:1568981363
Name:SCOTT, JOY LEIGH
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:LEIGH
Last Name:SCOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94697 US HIGHWAY 60
Mailing Address - Street 2:
Mailing Address - City:POND CREEK
Mailing Address - State:OK
Mailing Address - Zip Code:73766-5011
Mailing Address - Country:US
Mailing Address - Phone:580-541-4409
Mailing Address - Fax:
Practice Address - Street 1:715 S 10TH ST
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-6384
Practice Address - Country:US
Practice Address - Phone:580-541-4409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-12
Last Update Date:2017-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK333225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist