Provider Demographics
NPI:1780620872
Name:SCOTT, LAURA J (OT)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:J
Last Name:SCOTT
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 STONEYBROOK RD
Mailing Address - Street 2:
Mailing Address - City:HAMPDEN
Mailing Address - State:ME
Mailing Address - Zip Code:04444-1623
Mailing Address - Country:US
Mailing Address - Phone:207-862-4946
Mailing Address - Fax:
Practice Address - Street 1:881 POPLAR ST
Practice Address - Street 2:
Practice Address - City:OLD TOWN
Practice Address - State:ME
Practice Address - Zip Code:04468-5918
Practice Address - Country:US
Practice Address - Phone:207-433-7778
Practice Address - Fax:207-433-7780
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT1381225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEP00294503OtherRAILROAD MEDICARE
MEP00294503OtherRAILROAD MEDICARE