Individual
SANDRA BARNES SCOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6578 WILLOW ST, MOUNT DORA, FL 32757
(352) 321-0969
Mailing address
PO BOX 453, ZELLWOOD, FL 32798-0453
(352) 321-0969
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019921700
—
FL
Enumeration date
02/08/2022
Last updated
02/08/2022
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