Provider Demographics
NPI:1447249164
Name:SCOTT, SHEILA
Entity type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:
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 1:7318 BATAVIA RD
Mailing Address - Street 2:
Mailing Address - City:DIXON
Mailing Address - State:CA
Mailing Address - Zip Code:95620-9734
Mailing Address - Country:US
Mailing Address - Phone:707-423-7822
Mailing Address - Fax:
Practice Address - Street 1:100 BODIN CIR
Practice Address - Street 2:ATTN: OCCUPATIONAL THERAPY
Practice Address - City:TRAVIS AFB
Practice Address - State:CA
Practice Address - Zip Code:94535-1804
Practice Address - Country:US
Practice Address - Phone:707-423-7822
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1086225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist