Individual
MRS. KELLIE OLIVER SCOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
705 GANDY ST NE, RUSSELLVILLE, AL 35653-1913
(256) 332-1611
Mailing address
724 GRAVEL HILL RD, PHIL CAMPBELL, AL 35581-4304
(256) 436-1706
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3197
AL
Other
Enumeration date
07/19/2011
Last updated
07/19/2011
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