Provider Demographics
NPI:1861688145
Name:SCOTT, TERRENCE (COTA/L)
Entity Type:Individual
Prefix:MR
First Name:TERRENCE
Middle Name:
Last Name:SCOTT
Suffix:
Gender:M
Credentials:COTA/L
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 67
Mailing Address - Street 2:
Mailing Address - City:HODGES
Mailing Address - State:SC
Mailing Address - Zip Code:29653-0067
Mailing Address - Country:US
Mailing Address - Phone:864-337-1183
Mailing Address - Fax:864-456-2123
Practice Address - Street 1:522 SALLY WHITE RD
Practice Address - Street 2:
Practice Address - City:HODGES
Practice Address - State:SC
Practice Address - Zip Code:29653-9374
Practice Address - Country:US
Practice Address - Phone:864-337-1183
Practice Address - Fax:864-456-2123
Is Sole Proprietor?:No
Enumeration Date:2007-09-19
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2467224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant