Provider Demographics
NPI:1902204456
Name:SCOTT, EMILY ANNE (COTA)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:ANNE
Last Name:SCOTT
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 1:12 WATER ST
Mailing Address - Street 2:
Mailing Address - City:FORESTVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14062-9608
Mailing Address - Country:US
Mailing Address - Phone:716-965-2742
Mailing Address - Fax:
Practice Address - Street 1:12 WATER ST
Practice Address - Street 2:
Practice Address - City:FORESTVILLE
Practice Address - State:NY
Practice Address - Zip Code:14062-9608
Practice Address - Country:US
Practice Address - Phone:716-965-2742
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-16
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY64-007954224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant