Provider Demographics
NPI:1619087780
Name:FERRIN, SCOTT DUANE (OTR/L)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:DUANE
Last Name:FERRIN
Suffix:
Gender:M
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 1:961 N HIGH SCHOOL AVE
Mailing Address - Street 2:
Mailing Address - City:THATCHER
Mailing Address - State:AZ
Mailing Address - Zip Code:85552-5638
Mailing Address - Country:US
Mailing Address - Phone:928-241-2091
Mailing Address - Fax:
Practice Address - Street 1:961 N HIGH SCHOOL AVE
Practice Address - Street 2:
Practice Address - City:THATCHER
Practice Address - State:AZ
Practice Address - Zip Code:85552-5638
Practice Address - Country:US
Practice Address - Phone:928-241-2091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2442225X00000X
NM2026225X00000X
OK1634225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ840331Medicaid