Provider Demographics
NPI:1477717619
Name:SCOTT, KARI ANNE (COTA)
Entity type:Individual
Prefix:MRS
First Name:KARI
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 1:3755 CENTERSTONE PKWY
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:IN
Mailing Address - Zip Code:46774-2279
Mailing Address - Country:US
Mailing Address - Phone:260-748-4546
Mailing Address - Fax:
Practice Address - Street 1:2510 E DUPONT RD STE 237
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46825-1603
Practice Address - Country:US
Practice Address - Phone:260-490-6535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN32001636A224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant