Basic Information
| Provider Information | |||||||||
| NPI: | 1932826815 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCOTT | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | ANNE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3981 NW 122ND ST APT C | ||||||||
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| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731208240 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4065997512 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2401 NW 23RD ST STE 2D | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731072420 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4053553239 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/21/2022 | ||||||||
| LastUpdateDate: | 10/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/21/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.