Provider Demographics
NPI:1144578865
Name:SCOTT, MAEVE INGRID
Entity type:Individual
Prefix:MISS
First Name:MAEVE
Middle Name:INGRID
Last Name:SCOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 ORCHARD ST
Mailing Address - Street 2:BOX 166
Mailing Address - City:PLEASANT CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43772
Mailing Address - Country:US
Mailing Address - Phone:740-255-1584
Mailing Address - Fax:
Practice Address - Street 1:61074 SOUTHGATE RD
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43725-9414
Practice Address - Country:US
Practice Address - Phone:740-439-4014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-28
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.020397 S225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist