Provider Demographics
NPI:1821468380
Name:CAMEY SCARSELLA, ANNE MARIE (COTA)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:MARIE
Last Name:CAMEY SCARSELLA
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2805 PARK COLONY DR
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30093-1679
Mailing Address - Country:US
Mailing Address - Phone:678-283-5567
Mailing Address - Fax:
Practice Address - Street 1:2805 PARK COLONY DR
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30093-1679
Practice Address - Country:US
Practice Address - Phone:678-283-5567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-28
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOTA001704224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant