Provider Demographics
NPI:1952868192
Name:SCOTT, SABRINA ELLIOTT
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:ELLIOTT
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 1:223 DOGWOOD LN
Mailing Address - Street 2:
Mailing Address - City:HURT
Mailing Address - State:VA
Mailing Address - Zip Code:24563-2142
Mailing Address - Country:US
Mailing Address - Phone:434-841-4408
Mailing Address - Fax:
Practice Address - Street 1:1317 LOLA AVE
Practice Address - Street 2:
Practice Address - City:ALTAVISTA
Practice Address - State:VA
Practice Address - Zip Code:24517-1352
Practice Address - Country:US
Practice Address - Phone:434-369-6651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-25
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2306603561225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant