Provider Demographics
NPI:1528542339
Name:SCOTT, HANNAH NICOLE (COTA)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:NICOLE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:NICOLE
Other - Last Name:SHIRELING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA
Mailing Address - Street 1:11417 BRAHMAN RD
Mailing Address - Street 2:
Mailing Address - City:LITHIA
Mailing Address - State:FL
Mailing Address - Zip Code:33547-2007
Mailing Address - Country:US
Mailing Address - Phone:813-579-7548
Mailing Address - Fax:
Practice Address - Street 1:702 S KINGS AVE
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5959
Practice Address - Country:US
Practice Address - Phone:813-651-1818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA16313224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant