Individual
MS. KIA SHANIC SCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1525 FEDERAL ST, PHILADELPHIA, PA 19146-3147
(267) 223-5258
Mailing address
1525 FEDERAL ST, PHILADELPHIA, PA 19146-3147
(267) 223-5258
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC009986
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
YXH4025960300
KEYSTONE
PA
Enumeration date
06/27/2013
Last updated
06/27/2013
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