Organization
ABOUT THE MINORS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY SCOTT (DIRECTOR/OWNER)
(804) 295-3382
Entity
Organization
Contact information
Practice address
13 N SYCAMORE ST, PETERSBURG, VA 23803-3233
(804) 295-3382
Mailing address
2421 FORT LEE RD, PETERSBURG, VA 23803-4857
(804) 295-3382
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
—
—
225A00000X
Music Therapist
—
—
226000000X
Recreational Therapist Assistant
—
—
374T00000X
Religious Nonmedical Nursing Personnel
—
—
Other
Enumeration date
04/17/2023
Last updated
04/17/2023
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